{"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":463.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":143.2,"expiration_date":"9999-12-31","billing_class":"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":"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":274.07,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":88.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":100.97,"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":34.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","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":"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":"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":"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":"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":55.61,"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":"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":"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":157.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":507.41,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":106.67,"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":154.68,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":379.82,"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":123.08,"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":"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":"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":"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":"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":"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":2.85,"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":"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":"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":"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":"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":"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":"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":510.83,"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":"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":"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":97.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":14.43,"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":10.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":274.4,"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":346.26,"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":"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":"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":2218.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":1427.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":59.84,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":567.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":46.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":186.72,"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":"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":"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":"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":"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":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"]},{"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"]}],"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","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":41.75,"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":24.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":58.43,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":301.56,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":1336.22,"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":"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":"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":"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":"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":"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":"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":241.17,"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":132.55,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2366.64,"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":207.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":79.74,"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":41.42,"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":"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":21.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":28.64,"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":[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":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":270.13,"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":"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":"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":89.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":96.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":99.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":101.16,"expiration_date":"9999-12-31","billing_class":"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":19.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":329.86,"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":172.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":258.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":50.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2327.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":54.4,"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":"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":"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":"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":"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":200.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":37.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":327.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":34.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2115.12,"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":"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":38.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":83.91,"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":"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":"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":"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":2641.26,"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":189.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":21.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":28.64,"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":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":47.2,"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":37.21,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":397.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":2026.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":42.2,"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":144.94,"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":"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":"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":"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":192.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":39.29,"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":"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":"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":"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":"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":"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":"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":"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":24.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":125.19,"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":75.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":82.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":76.52,"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":126.17,"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":"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":"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":38.88,"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":"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":"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":"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":"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":2294.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.4,"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":"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":25.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":79.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":82.58,"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":96.8,"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":14.82,"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":10.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":132.27,"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":269.09,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":32.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":101.9,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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":"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":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":78.65,"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":"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":"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":"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":"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":"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":1988.09,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":21.29,"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":"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":"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":"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":186.3,"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":105.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":797.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":58.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":15.85,"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":"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":"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":"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":"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":"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":40.46,"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":49.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":74.44,"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":"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":"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":"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":"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":"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":"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":26.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":210.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.0,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":354.94,"expiration_date":"9999-12-31","billing_class":"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.23,"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":"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":"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":"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":"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":"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":"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":11.12,"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":7.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":277.97,"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":"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":"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":"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":"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":16.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":23.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":37.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":14.7,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":126.71,"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":68.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":50.51,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":13.7,"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":9.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95810","name":"Polysom 6/> yrs 4/> param","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":160.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":42.54,"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":22.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":709.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":7.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":35.7,"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":93.03,"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":"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":"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":"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":"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":"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":"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":"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":32.75,"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":105.44,"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":[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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.81,"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":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.3,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":920.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":320.99,"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":"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":21.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":34.39,"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":"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":"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":"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":"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":18.32,"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":24.54,"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":50.51,"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":"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":"negotiated","negotiated_rate":302.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":43.49,"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":23.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":95.98,"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":200.21,"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":[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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.48,"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2249.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":76.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":137.24,"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":537.86,"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":859.39,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":82.6,"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":133.07,"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":"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":"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":"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":"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":"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":"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":"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":6.65,"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":15.97,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":125.75,"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":329.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1438.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":137.85,"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":531.7,"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":"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":"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":"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":54.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":63.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":214.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":269.97,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":337.88,"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":"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":"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":"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":"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":"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":"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":"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":1178.46,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":22.79,"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":"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":"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":"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":"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":"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":"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":"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":85.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":220.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":147.62,"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":105.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.29,"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":"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":23.93,"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":17.24,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-06","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"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":"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":"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":"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":1.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":198.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":71.35,"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":116.89,"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":"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":"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":"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":"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":36.26,"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":"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":"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":22.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":319.31,"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":"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":"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":113.75,"expiration_date":"9999-12-31","billing_class":"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","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":481.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":97.05,"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":53.82,"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":"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":"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":140.79,"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":70.32,"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":"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":85.09,"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":118.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":30.6,"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":"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":76.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":38.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":109.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":76.72,"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":39.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":54.44,"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":"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":50.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":43.43,"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":24.16,"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":"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":"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":"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":"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":"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":175.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":144.63,"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":222.92,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":246.99,"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":304.1,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.48,"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":"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":"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":"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":231.4,"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":117.45,"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":137.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":66.56,"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":56.79,"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":[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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":109.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":113.16,"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":67.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":138.91,"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":89.76,"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":"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":"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":"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":"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":"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":"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":"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":1204.01,"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":"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":6.22,"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":"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":"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":18.44,"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":"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":"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":"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":1.37,"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":5.51,"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":"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":"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":"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":"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":"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":32.36,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":94.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":954.09,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":366.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":27.35,"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":21.04,"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":"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":"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":"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":"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":1.69,"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":"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":"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":"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":"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":"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":"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":"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":380.43,"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":310.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1063.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":45.08,"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":"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":"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":"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":"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":78.95,"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":30.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":229.5,"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":142.76,"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":"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":"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":"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":78.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":116.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":353.93,"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":"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":"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":"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":"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":"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":"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":"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":19.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":24.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":38.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":21.04,"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":27.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":100.69,"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":"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":"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":"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":91.39,"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":36.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":28.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.32,"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":"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":"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":"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":558.99,"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":104.27,"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":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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":13.28,"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":9.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":89.28,"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":"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":"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":114.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.46,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":23.16,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.97,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":213.12,"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":131.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2447.2,"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":32.3,"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":19.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":171.96,"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":"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":"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":52.72,"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":"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":"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":"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":3.8,"expiration_date":"9999-12-31","billing_class":"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1105.94,"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":"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":"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":"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":"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":9.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1922.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-06","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":58.62,"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":"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":"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":"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":"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":"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":"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":"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":72.07,"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":49.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":770.0,"expiration_date":"9999-12-31","billing_class":"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":"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":110.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":333.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":39.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":34.11,"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":"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":"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":110.5,"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":65.67,"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":[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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":22.8,"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":40.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":119.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":93.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":158.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":35.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":214.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":30.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":44.29,"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":"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":"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":"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":"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":"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":"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":"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":54.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":91.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":136.19,"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":162.1,"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":"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":"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":"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":"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":25.95,"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":"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":"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":"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":"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":"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":"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":25.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":43.06,"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":"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":"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":"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":"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":"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":29.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":119.11,"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":64.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":80.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":353.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":417.18,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":392.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":6.06,"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":"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":"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":14.57,"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":10.4,"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":"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":"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":"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":177.83,"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":97.46,"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":"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":"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":"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":2347.38,"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":201.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":115.73,"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":"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":"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":"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":"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":"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":23.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1055.14,"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":85.19,"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":[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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":45.58,"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":73.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.03,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":40.58,"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":"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":"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":"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":"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":"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":"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":5.9,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":34.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":39.1,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.92,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":377.3,"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":304.53,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82382","name":"Assay urine catecholamines","description":"Catecholamines; total urine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":"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":55.96,"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":"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":"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":"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":"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":"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":"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":72.25,"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":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":95.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":241.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":90.69,"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":50.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":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"]},{"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"]}],"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","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":110.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":333.02,"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":"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":"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":"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":"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":"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":103.43,"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":1777.15,"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":"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":391.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":38.99,"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":68.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":113.22,"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":34.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":36.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":342.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":398.38,"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":655.64,"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":77.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28261","name":"Revision of foot tendon","description":"Capsulotomy, midfoot; with tendon lengthening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":108.63,"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":71.08,"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":8.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.63,"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":"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":"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":"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":"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":"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":2687.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":141.25,"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":62.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":6.66,"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":"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":"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":148.76,"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":190.22,"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":"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":"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":"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":"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":120.27,"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":270.91,"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":"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":"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":51.16,"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":99.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":137.82,"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":255.08,"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":"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":"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":"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":"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":"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":"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":761.23,"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":55.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":286.07,"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":114.63,"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":88.22,"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":148.01,"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":[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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":81.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":198.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":357.8,"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":"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":"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":"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":"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":"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":"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":"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":137.85,"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":531.7,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":31.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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":"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":49.62,"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":28.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":26.03,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"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":"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":"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":"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":"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":"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":"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":52.51,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":768.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":89.15,"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":"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":"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":"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":"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":"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":70.71,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.8,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.57,"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":136.84,"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":"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":26.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":620.99,"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":"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":116.54,"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":59.9,"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":"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":"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":"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":"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":54.58,"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":34.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":62.25,"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":90.55,"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":[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":"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":1.63,"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":"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":659.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":451.55,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.48,"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":"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":"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":"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":140.84,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":83.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":26.5,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":103.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":152.19,"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":87.46,"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":"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":"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":"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":"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":"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":"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":"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":315.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":66.23,"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":41.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":644.45,"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":150.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":153.92,"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":274.14,"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":[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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":82.12,"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":"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":"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":17.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":62.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":34.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":192.31,"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":75.22,"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":[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":"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":"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":"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":84.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":160.89,"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":77.78,"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":[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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":22.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":124.89,"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":37.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2219.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":91.16,"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":187.72,"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":"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":"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":"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":"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":"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":59.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":171.55,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":65.48,"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":145.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":49.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":121.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.3,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":32.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":48.42,"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":"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":"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":"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":"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":"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":"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":118.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.71,"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":"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":"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":"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":"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":"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":"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":"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":87.33,"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":"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":"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":"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":"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":38.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":133.75,"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":73.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":164.42,"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":199.8,"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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38720","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (complete)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","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":"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":"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":113.8,"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":224.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":129.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":32.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":86.45,"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":111.33,"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":2.95,"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":"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":"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":"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":"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":36.73,"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":72.47,"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":26.41,"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":"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":"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":"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":"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":"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":24.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":71.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":133.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":21.36,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":68.2,"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":137.48,"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":"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":"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":"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":26.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":44.45,"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":"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":"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":94.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":954.09,"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":8.9,"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":13.04,"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":"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":"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":"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":"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":"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":100.34,"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":56.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":82.6,"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":133.07,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.07,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":187.02,"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":101.73,"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":"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":"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":"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":"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":"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":"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":18.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":68.92,"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":47.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.2,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.22,"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":"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":"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":15.71,"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":26.13,"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":"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":"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":"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":"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":14.96,"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":"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":"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":"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":135.95,"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":162.3,"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":"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":"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":"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":28.94,"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":21.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.5,"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":"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":"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":"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":"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":530.51,"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":66.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":6.47,"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":"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":"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":"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":30.24,"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":"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":"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":"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":"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":"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":"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":"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":18.41,"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":"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":"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":970.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":14.96,"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":"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":"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":15.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":301.41,"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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":33.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":62.15,"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":"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":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":138.74,"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":223.78,"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":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50526","name":"Close nephrovisceral fistula","description":"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach","date_of_service":"2026-06-06","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":98.13,"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":116.18,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54111","name":"Treat penis lesion graft","description":"Excision of penile plaque (peyronie disease); with graft to 5 cm in length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":1.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":54.83,"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":19.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","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"]}],"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":54.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":13.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":143.6,"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":87.05,"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":"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":115.5,"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":47.4,"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":153.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":731.44,"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":"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":"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":"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":"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":"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":"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":124.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":33.91,"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":73.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":875.39,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":16.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":20.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":425.75,"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":354.94,"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":"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":"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":"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":"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":"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":"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":2810.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":58.55,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":773.9,"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":"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":"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":104.39,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":1105.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":805.16,"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":"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":"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":"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":"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":"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":"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":25.88,"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":"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":"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":"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":"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":"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":5.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":844.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":40.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"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":"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":"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":"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":"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":"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":14.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":136.85,"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":310.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.28,"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":"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":"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":"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":"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":"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":"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":"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":32.96,"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":18.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":49.77,"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":66.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":72.08,"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":61.02,"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":"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":"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":"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":"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":"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":"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":58.27,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"1328299","zip":"12007","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":34.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"expiration_date":"9999-12-31","billing_class":"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","locality":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":13.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.91,"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":"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":"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":"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":"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":"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":3277.46,"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":119.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":158.88,"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":93.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":859.39,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.4,"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":14.57,"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":"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":"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":"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":298.29,"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":374.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":342.14,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":45.23,"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":16.91,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":102.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-06","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.75,"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":16.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.14,"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":78.05,"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":"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":"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":"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":"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":"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":"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":"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":27.98,"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":16.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.17,"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":6.39,"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":"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":"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":"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":"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":"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":"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":"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":283.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":37.1,"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":23.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":62.68,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":8.89,"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":"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":"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":330.37,"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":146.11,"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":[1]}]},{"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":128.18,"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":1358.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":184.4,"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":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":[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":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":21.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1151.34,"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":"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":"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":127.08,"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":45.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":52.72,"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":"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":"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":"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":"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":"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":"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":213.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":226.43,"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":76.63,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":567.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":24.53,"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":"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":"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":"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":"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":"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":"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":"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":"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":78.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":45.96,"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":"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":"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":"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":27.95,"expiration_date":"9999-12-31","billing_class":"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":"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"]},{"negotiated_type":"negotiated","negotiated_rate":39.45,"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","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":72.51,"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":122.85,"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":"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":"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":1876.82,"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":"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":45.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":54.58,"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":34.11,"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":"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":"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":1661.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":54.62,"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":72.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":50.63,"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":62.69,"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":"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":"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":"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":"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":"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":"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":213.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":213.33,"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":"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":"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":"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":"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":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":152.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":224.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":322.83,"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":"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":52.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":59.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.61,"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":"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":"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":"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":"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":"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":"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":"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":148.27,"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":53.55,"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":36.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":141.83,"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":87.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"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":"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":"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":412.53,"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":133.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":445.09,"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":"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":"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":"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":"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":"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":"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":"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":161.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":83.26,"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":"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":"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":"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":153.55,"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":38.6,"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":"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":82.12,"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":"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":210.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":115.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":153.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":39.94,"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":21.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":74.47,"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":122.79,"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":[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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"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":"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":"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":"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":"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":52.19,"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":"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":"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":"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":"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":"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":61.58,"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":118.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":92.31,"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":72.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3161.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2101.81,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":41.73,"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":28.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":82.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":462.65,"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":"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":"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":"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":"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":77.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":117.1,"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":169.22,"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":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":"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":"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":"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":4.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":80.29,"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":37.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":661.4,"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":"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":"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":"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":"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":"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":285.77,"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":"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":"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":"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":302.39,"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":"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":"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":"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":3.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":218.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":278.9,"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":"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":"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":"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":18.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":345.56,"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":120.2,"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":"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":36.17,"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":15.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":31.71,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.63,"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":"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":"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":"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":"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":"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":"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":"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":"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":255.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1055.14,"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":85.19,"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":[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":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":119.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":371.58,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":121.76,"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":49.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50431","name":"Njx px nfrosgrm &/urtrgrm","description":"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access","date_of_service":"2026-06-06","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":200.21,"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":95.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":103.05,"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":"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":"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":"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":"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":"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":"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":"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":11.24,"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":"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":"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":"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":"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":"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":"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":"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":16.91,"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":45.23,"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":[2]}]},{"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":"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":"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":"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":"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":99.14,"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":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":[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":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.35,"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":370.93,"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":"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":"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":"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":"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":77.92,"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":129.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":6.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":541.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":183.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":22.81,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":228.02,"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":139.79,"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":[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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":17.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":24.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98962","name":"Edu&trn pt slf-mgmt nqhp 5-8","description":"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 5-8 patients","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":63.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":134.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.21,"expiration_date":"9999-12-31","billing_class":"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":17.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":47.96,"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":19.43,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":353.78,"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":19.29,"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":"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":"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":"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":"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":"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":"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":13.57,"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":"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":"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":26.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":206.41,"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":124.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":123.32,"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":197.09,"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":"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":"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":22.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[4]}]},{"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":"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":42.01,"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":54.44,"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":[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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":27.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":316.89,"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":"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":"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":"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":"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":"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":"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":"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":103.49,"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":267.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":62.45,"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":"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":"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":"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":92.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":70.1,"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":119.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":309.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":6.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":122.79,"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":74.47,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":96.41,"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":[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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":1105.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":43.76,"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":"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":"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":"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":"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":996.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":966.39,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":80.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":87.46,"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":152.19,"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":"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":6.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":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"]},{"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":48.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":646.17,"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":78.26,"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":"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":"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":"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":"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":121.21,"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":49.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","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":"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":"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":"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","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":16.78,"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":23.09,"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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":219.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":96.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.77,"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":124.75,"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":"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":"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":"negotiated","negotiated_rate":266.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":310.57,"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":380.43,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.39,"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":"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":"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":"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":"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":153.05,"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":72.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":183.2,"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":"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":"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":"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":2839.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":81.45,"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":104.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":22.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":5.9,"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":30.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":78.95,"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":[4]}]},{"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":"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":"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":"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":"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":"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":366.15,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":15.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":282.79,"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":"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":18.77,"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":25.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":78.71,"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":"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":"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":"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":"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":"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":"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":"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":247.45,"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":"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":"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":"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":"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":148.01,"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":"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":"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":"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":"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":187.02,"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":101.73,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":17.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":24.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":163.53,"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":"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":"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":"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":"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":"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":"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":"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":"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":2366.64,"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":207.8,"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.07,"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":"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":"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":"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":"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":43.43,"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":24.16,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":63.18,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":977.16,"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":65.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":45.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":218.3,"expiration_date":"9999-12-31","billing_class":"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":157.76,"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":93.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":84.22,"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":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":49.19,"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":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":73.43,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.9,"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":116.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.35,"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":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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47600","name":"Cholecystectomy","description":"Cholecystectomy;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":"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":"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":60.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.79,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":116.83,"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":73.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.98,"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":"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":"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":"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":"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":"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":"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":2068.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":190.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":314.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":147.51,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":52.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.24,"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":133.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":248.58,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":61.04,"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":89.17,"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":[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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":143.78,"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":42.77,"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":"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":"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":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"]},{"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"]}],"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":73.4,"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":33.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":76.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2327.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.78,"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":"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":6.07,"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":"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":"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":"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":"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":"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":"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":48.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":130.37,"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":75.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":35.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":102.23,"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":[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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1065.71,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":30.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":52.19,"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":"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":79.04,"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":"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":"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":"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":"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":"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":"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":"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":118.2,"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":35.63,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":199.05,"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":96.59,"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":"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":"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":"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":"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":"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":"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":75.71,"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":42.24,"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":"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":"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":"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":"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":"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":"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":152.16,"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":21.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":38.85,"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":"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":"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":"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":"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":7.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":776.7,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":100.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1491.96,"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":"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":1733.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.73,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.24,"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":"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":"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":82.31,"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":134.7,"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":[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":229.5,"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":142.76,"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":"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":"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":"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":"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":"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":"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":65.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":117.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":67.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":126.8,"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":[4]}]},{"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":"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":"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":58.16,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":174.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1141.75,"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":"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":"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":158.6,"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":"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":"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":"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":"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":66.09,"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":40.62,"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":[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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1.57,"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":"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":"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":50.6,"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":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":5.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":151.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":243.43,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":117.45,"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":185.75,"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":"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":"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":"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":"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":"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":"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":34.3,"expiration_date":"9999-12-31","billing_class":"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"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":"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":"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":"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":144.61,"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":"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":"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":"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":"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":111.77,"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":73.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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":"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":"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":32.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":90.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":97.84,"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":"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":76.69,"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":54.08,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.05,"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":"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":"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":"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":"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":67.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":113.16,"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":35.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":257.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":222.92,"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":144.63,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":54.35,"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":42.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.21,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":5.9,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2839.76,"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":"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":"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":"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":"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":"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":"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":"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":6.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2447.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":87.68,"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":"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":"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":"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":"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":"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":"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":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":48.95,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":233.95,"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":"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":"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":"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":58.3,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":39.76,"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":102.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2035.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":55.63,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":17.57,"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":25.52,"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":"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":"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":"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":"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":"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":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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.41,"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":40.84,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":23.46,"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":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":744.88,"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":"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":37.61,"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":"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":"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":"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":"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":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":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":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":"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":"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":"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":"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":"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":"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":"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":"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":17.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":24.38,"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":"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":"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":"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":"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":"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":"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":"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":78.14,"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":30.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["26"]}],"provider_references":[4]}]},{"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":"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":"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":"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":70.43,"expiration_date":"9999-12-31","billing_class":"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":89.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":329.14,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-06","zip":"13143","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":"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":"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":"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":"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":"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":"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":66.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":132.01,"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":[3]}]},{"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":"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":"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":"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":"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":"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":41.84,"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":92.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":35.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":26.72,"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":"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":"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":"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":"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":"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":"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":"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":54.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.0,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":140.51,"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":119.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":348.67,"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":"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":"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":"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":"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":"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":"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":"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":36.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":135.45,"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":1464.05,"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":"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":"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":"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":"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":"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":"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":"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":119.11,"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":64.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":21.88,"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":28.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":271.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":80.54,"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":"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":"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":"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":7.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":42.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":48.74,"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":"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":"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":"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":"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":"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":"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":1.63,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":87.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.24,"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":"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":"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":136.84,"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":215.57,"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":[3]}]},{"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":3949.58,"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":320.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.8,"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":"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":"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":"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":"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":"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":"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":"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":67.01,"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":"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":"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":"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":100.28,"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":118.61,"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":"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":"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":"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":47.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":121.57,"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":[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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64738","name":"Incision of jaw nerve","description":"Transection or avulsion of; inferior alveolar nerve by osteotomy","date_of_service":"2026-06-06","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":"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":"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":"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":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"]},{"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"]}],"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.41,"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":"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":"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":"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":"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":"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":"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":43.49,"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":175.97,"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":"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":"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":"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":"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":"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":"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":83.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":173.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":53.13,"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":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":"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":"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":98.8,"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":"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":10.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":15.64,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15050","name":"Pinch graft up to 2 cm diam","description":"Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on face), up to defect size 2 cm diameter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":189.04,"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":141.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2641.26,"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":"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":"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":"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":"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":"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":74.94,"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":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"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":33.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":66.59,"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":"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":"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":23.87,"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":"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":"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":"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":"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":"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":"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":646.17,"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":78.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":636.47,"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":"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":33.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":13.49,"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":5.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.15,"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":"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":"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":"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":"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":"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":"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":12.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1479.82,"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":143.36,"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":"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":"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":"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":"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":2.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.01,"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":"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":"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":"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":392.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":29.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":419.78,"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":"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":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":53.4,"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":"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":"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":"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":"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":"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":"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":1760.51,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":110.5,"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":65.67,"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":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":253.01,"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":196.14,"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":[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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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":[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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":18.65,"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":"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":"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":35.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":143.51,"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":86.03,"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":"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":"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":"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":"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":"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":191.26,"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":47.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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":"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":"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":"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":"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":"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":15.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":29.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":44.09,"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":"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":"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":"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":"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":"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":"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":"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":"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":25.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":1083.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":381.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":226.1,"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":113.88,"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":"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":"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":"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":928.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":22.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":26.28,"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":"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":"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":"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":"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":"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":"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":"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":45.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":56.42,"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":"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":"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":"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":49.0,"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":26.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_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":"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":"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":"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":"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":"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":"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":"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":"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":"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":68.21,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":88.91,"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":61.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":35.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"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":"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":"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":18.21,"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":26.66,"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":"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":"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":"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":95.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1051.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":21.15,"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":26.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2687.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1764.79,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1427.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":309.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":131.72,"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":270.89,"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":"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":"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":"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":"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":"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":"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":72.65,"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":23.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":234.96,"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":"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":2.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"H2019","name":"Ther behav svc, per 15 min","description":"Therapeutic behavioral services, per 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["U5"]}],"provider_references":[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":"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":"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":"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":"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":1273.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.12,"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":"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":"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":2.95,"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":"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":"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":"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":"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":18.88,"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":"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":"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":"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":"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":5.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1101.47,"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":"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":"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":"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":861.52,"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":"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":"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":"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":15.17,"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":6.39,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.48,"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":"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":"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":"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":"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":"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":"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":3.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":66.9,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":94.97,"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":"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":"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":"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":"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":"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":1.37,"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":5.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":33.8,"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":52.27,"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":"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":"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":"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":284.3,"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":115.76,"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":"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":"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":"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":"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":98.8,"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":40.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.01,"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":"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":28.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":27.45,"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":16.39,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":80.06,"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":572.79,"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[4]}]},{"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2032.78,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":734.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.71,"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":"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":"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":"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":"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":"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":"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":"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":28.44,"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":17.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2641.1,"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":103.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":53.13,"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":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":47.72,"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":34.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","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":"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":"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":"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":"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":"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":29.18,"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":22.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":141.95,"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":67.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":171.13,"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":84.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":269.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":75.64,"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":"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":"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":"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":135.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.23,"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":"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":"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":"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":"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":2.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":998.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":130.41,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":73.43,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":57.49,"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":"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":"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":"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":"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":31.04,"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":103.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":544.21,"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":98.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":141.22,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.87,"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":15.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":133.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":235.58,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.93,"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":"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":"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":"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":"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":44.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":31.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":82.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":905.45,"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":146.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":110.63,"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":"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":"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":"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":"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":"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":"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":"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":4.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1750.94,"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":"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":"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":"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":"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":54.48,"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":73.14,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":659.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":117.55,"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":207.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":54.44,"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":42.01,"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":73.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":111.77,"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":"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":"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":"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":"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":1060.5,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":119.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":165.37,"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":"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":"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":"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":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"]},{"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"]}],"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":26.5,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1256.48,"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":"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":"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":"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":"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":"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":"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":"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":174.25,"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":99.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":114.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":226.54,"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":"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":"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":40.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":55.1,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":153.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":42.03,"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":"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":"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":"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":1199.84,"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":"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":"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":"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":"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":"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":856.31,"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":363.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":124.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":99.72,"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":37.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","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":"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":"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":"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":"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":"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":"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":"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":"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":48.4,"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":82.65,"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":26.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":73.36,"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":62.04,"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":"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":"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":"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":"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":1922.42,"expiration_date":"9999-12-31","billing_class":"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":31.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":13.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":68.26,"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":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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":358.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":275.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":398.81,"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","locality":"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":"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":"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":157.76,"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":93.2,"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":"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":"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":"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":"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":771.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":665.93,"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":"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":171.96,"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":"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":94.41,"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":"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":"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":"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":"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":"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":"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":19.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":501.05,"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":338.79,"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":[4]}]},{"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":"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":167.33,"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":263.09,"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":"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":"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":"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":"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":"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":29.18,"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":22.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":776.7,"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":"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":6.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":2244.14,"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":180.32,"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":"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":"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":"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":"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":"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":"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":"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":123.4,"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":55.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":165.29,"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":81.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":423.14,"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":148.28,"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":[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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":53.36,"expiration_date":"9999-12-31","billing_class":"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":152.63,"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":194.33,"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":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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":189.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":169.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[3]}]},{"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":127.33,"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":72.23,"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":"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":"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":"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":"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":14.82,"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":10.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":"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":"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":"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":76.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":241.14,"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":93.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":155.66,"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":"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":"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":4.85,"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":"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":"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":"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":"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":15.61,"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":"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":"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":"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":"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":29.41,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":75.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":49.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":83.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":108.61,"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":267.44,"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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.67,"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":"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":"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":"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":"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":"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":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":28.17,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":510.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":12.39,"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":"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":"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":19.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":36.87,"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":"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":"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":"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":"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":"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":"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":41.75,"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":58.43,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":3.07,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1039.88,"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":164.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1416.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":49.14,"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":125.09,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.02,"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":18.77,"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"]}],"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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86615","name":"Bordetella antibody","description":"Antibody; bordetella","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","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":"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":"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":"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":"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":"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":"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":"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":3.22,"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":42.54,"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":22.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":83.71,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"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":"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":"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":"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":"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":"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":"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":"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":"CPT","billing_code_type_version":"2026","billing_code":"45347","name":"Sigmoidoscopy w/plcmt stent","description":"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.55,"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":166.51,"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":"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":"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":"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":"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":"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":"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":"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":"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":1.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":192.84,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":68.92,"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":47.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":91.06,"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":236.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":248.58,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":13.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":173.49,"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":2431.84,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":16.44,"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":"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":"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":"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":"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":1.63,"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":"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":"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":"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":494.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":14.02,"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":"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":"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":"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":2.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":42.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2218.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":234.14,"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":96.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":44.17,"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":"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":"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":"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":"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":"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":"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":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":"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":"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":7.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":86.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":52.38,"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":152.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":97.46,"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":177.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":121.52,"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":"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":"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":"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":"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":"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":"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":"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":390.17,"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":312.14,"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":1300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":97.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":135.69,"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":94.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":570.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":186.54,"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":"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":"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":21.36,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3034.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":97.94,"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":"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":"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":"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":"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":65.93,"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":111.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":58.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":84.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1733.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":81.14,"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":134.74,"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":"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":"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":36.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":29.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":35.18,"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":"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":"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":93.43,"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":46.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":49.67,"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":49.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":144.61,"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":"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":"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":64.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":280.51,"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":"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":29.89,"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":144.94,"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":42.2,"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":7534.3,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2580.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":63.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":42.74,"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":"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":"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":"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":"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":25.87,"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":"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":"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":"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":"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":"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":"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":"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":16.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":454.72,"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":158.03,"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":[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","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":44.36,"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":"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":"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":"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":27.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":119.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":140.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.85,"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":"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":"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":"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":"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":"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":31.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":119.36,"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":"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":"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":"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":"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":155.4,"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":2114.7,"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":"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":"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":"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":"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":"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":"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":36.2,"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":"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":"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":"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":"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":"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":133.7,"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":81.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"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":"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":"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":71.38,"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":"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":"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":"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":"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":"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":"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":"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":6.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":"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":670.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":30.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":44.29,"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":"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":"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":"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":"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":"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":58.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":139.43,"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":69.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":28.69,"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":21.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":41.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.6,"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":"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":3.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":14.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":68.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":134.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":61.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"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":"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":"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":175.94,"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":214.14,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":198.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":223.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":69.19,"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":31.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":60.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":188.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":643.07,"expiration_date":"9999-12-31","billing_class":"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":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":"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":"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":"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":"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":"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":"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":"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":83.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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":"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":123.18,"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":67.5,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":114.62,"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":35.69,"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":17.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.79,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.08,"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":"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":"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","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-06","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.22,"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":"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":9.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":13.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.99,"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":30.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":28.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":17.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1253.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":56.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.55,"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":"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":"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":"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":"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":"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":"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":"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":"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":216.02,"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":121.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":175.97,"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":43.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":267.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":25.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.86,"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":"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":"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":"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":53.93,"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":"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":"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":"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":"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":43.84,"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":"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":"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":"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":"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":50.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":80.93,"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":2994.45,"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":"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":"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":"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":"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":"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":"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":307.31,"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":378.38,"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":[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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":108.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":43.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.9,"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":"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":"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":"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":"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":"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":"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":12.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1099.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":44.46,"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":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":[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":66.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":132.01,"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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":3.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.07,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":66.68,"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":102.06,"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":"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":"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":"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":"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":"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":"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":"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":1350.56,"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":"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":"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":"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":2.85,"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":"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":"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":"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":"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":"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":"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":"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":147.62,"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":105.62,"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":73.73,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":22.8,"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":40.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":2.36,"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":"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":"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":"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":"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":"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":"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":16.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.41,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4009.22,"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":318.05,"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":"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":"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":"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":132.58,"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":96.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":147.1,"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":237.34,"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":"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":"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":"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":"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":139.37,"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2580.78,"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":"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":49.37,"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":27.33,"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":19.66,"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":"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":"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":"45349","name":"Sigmoidoscopy w/resection","description":"Sigmoidoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.16,"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":"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":"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":"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":"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":"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":"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":6.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.37,"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":5.51,"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":"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":"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":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"]},{"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"]}],"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":"1320203","zip":"10512","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":["TC"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":107.84,"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":80.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":153.92,"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":274.14,"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":[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":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":"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":"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":85.71,"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":43.84,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":50.84,"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":"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":"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":"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":75.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":198.79,"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":118.74,"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":9.97,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":69.7,"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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":29.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.9,"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":"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":68.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":28.69,"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":21.88,"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":"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":"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":"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":"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":"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":"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":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":48.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":117.35,"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":"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":"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":"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":"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":"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":"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":"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":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":45.58,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":152.22,"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":52.38,"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":[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":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":"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":"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":6.66,"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":"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":"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":"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":"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":"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":"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":"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":63.01,"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":42.16,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":65.14,"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":"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":"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":"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":"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":"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":"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":119.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":165.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":62.93,"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":"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":"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":8.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":12.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":21.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":74.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":25.88,"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":"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":"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":"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":"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":352.81,"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":286.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","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"],"billing_code_modifier":["TC"]}],"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":8.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":183.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":28.85,"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":"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":23.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":41.65,"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":"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":"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":6.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":927.7,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":39.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":76.72,"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":"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":"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":"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":192.77,"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":"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":"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":"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":"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":"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":"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":8.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":41.73,"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":28.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.94,"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":"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":"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":"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":"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":"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":1633.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":43.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":79.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":62.68,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":37.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":226.96,"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":115.1,"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":[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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.94,"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":"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":"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":"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":22.23,"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":"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":"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":"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":"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":"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":"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":"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":97.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":71.54,"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":"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":51.95,"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":40.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":45.59,"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":56.36,"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":"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":"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":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"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":314.33,"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":"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":"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":"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":"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":589.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":221.58,"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":22.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.85,"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":"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":"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":"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":"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":"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":"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":"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":1.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":17.5,"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":325.54,"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":61.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":59.39,"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":"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":"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":"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":"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":"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":"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":"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":69.14,"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":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":"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":"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":"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":"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":"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":"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":"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":34.97,"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":"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":"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":"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":"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":"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":"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":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":"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":"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":77.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":83.06,"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":136.97,"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":45.92,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":574.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":22.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":973.41,"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":"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":"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":"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":"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":"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":3.8,"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":"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":"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":"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":"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":"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":13.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1113.71,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":609.15,"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":73.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.39,"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":143.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":48.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":47.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":102.02,"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":39.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1359.14,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":557.03,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":89.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":49.62,"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":28.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":95.87,"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":113.15,"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":"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":"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":"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":7.33,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":70.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.4,"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":"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":"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":"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":"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":"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":17.28,"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":70.01,"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":"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":"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":"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":"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":72.96,"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":54.62,"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":[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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":115.72,"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":77.46,"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":"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":"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":"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":75.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":49.2,"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":26.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.25,"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":"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":"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":"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":"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":"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":14.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":75.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":130.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.61,"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":"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":50.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.17,"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":"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":"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":"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":"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":130.37,"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":76.81,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95249","name":"Cont gluc mntr pt prov eqp","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment, sensor placement, hook-up, calibration of monitor, patient training, and printout of recording","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":157.89,"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":"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":"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":"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":107.48,"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":1097.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":50.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":58.16,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95249","name":"Cont gluc mntr pt prov eqp","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment, sensor placement, hook-up, calibration of monitor, patient training, and printout of recording","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":39.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":350.96,"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":18.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.04,"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.85,"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59850","name":"Induced abortion 1+ njx","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":115.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":2347.38,"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":201.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1336.22,"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":"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":"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":"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":"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":"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":758.57,"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":145.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":200.54,"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":"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":6.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":92.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":80.63,"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":"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":"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":"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":"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":"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":99.86,"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":118.33,"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":30.62,"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":"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":"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":1148.19,"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":94.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":46.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":63.2,"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":48.2,"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"1320203","zip":"10512","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":[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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.53,"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":129.71,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-06","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1443.98,"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":137.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2165.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1829.32,"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":"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":"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":71.04,"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":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":"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":"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":"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":"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":"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":"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":"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":"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":298.29,"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":374.56,"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":"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":20.3,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":57.27,"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":46.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":57.38,"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":84.26,"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":"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":352.81,"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":286.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320203","zip":"10512","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":123.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.27,"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":68.01,"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":[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":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":57.57,"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":40.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":55.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.16,"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":"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":"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":"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":"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":"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":"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":"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":308.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":74.88,"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":146.66,"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":"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":"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":35.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":102.23,"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":23.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":5.03,"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":"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":"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":"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":"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":"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":"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":1002.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":65.91,"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":"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":"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":"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":"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":8.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1802.66,"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":"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":"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":"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":119.36,"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":"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":"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":"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":767.84,"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":"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":"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":94.37,"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":157.83,"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":"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":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"]},{"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"]}],"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","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":"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":"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":"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":"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":"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":"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":"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":29.72,"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":33.83,"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":"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":"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":"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":"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":"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":"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":84.14,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":19.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":25.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1598.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":250.09,"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":140.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":342.14,"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":"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":"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":"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":"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":"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":"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":"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":18.83,"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":24.49,"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":"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":"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":"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":3.22,"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":"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":"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":"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":"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":"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":39.8,"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":"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":"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":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":"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":35.49,"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":31.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":191.99,"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":"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":1302.98,"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":"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":"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":"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":"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":"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":"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":"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":4.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":127.08,"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":45.45,"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":"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":17.8,"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":24.65,"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":"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":"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":73.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":116.83,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":948.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":111.0,"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":67.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":33.55,"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":"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":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"]},{"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"]}],"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":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":"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":"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":44.75,"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":"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":"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":"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":"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":"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":17.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":28.44,"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":"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":"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":37.79,"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":92.9,"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":"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":"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":"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":"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":28.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":52.97,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":49.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":57.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":56.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":138.54,"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":56.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":165.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":336.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":645.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":37.98,"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":"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":"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":"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":"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":"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":"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":"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":62.92,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":13.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":90.04,"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":146.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":246.99,"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":304.1,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.23,"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":"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":245.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":173.87,"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":1118.43,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":165.9,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":22.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":342.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":13.89,"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":"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":"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":"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":"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":"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":"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":127.46,"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":"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":"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":"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":104.37,"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":"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":"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":"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":"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":"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":"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":970.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":99.14,"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":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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":149.78,"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":71.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":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":"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":"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":"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":"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":"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":19.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":70.01,"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":"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":"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":"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":11.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":270.24,"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":366.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":143.07,"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":72.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":2.69,"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":"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":"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":"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":"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":26.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":31.04,"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44145","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":248.55,"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":"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":"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":"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":"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":"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":"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":"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":"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":54.02,"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":38.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":13.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":9.93,"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","locality":"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":"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":"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":"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":"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":"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":"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":"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":2.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":16.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":327.39,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":17.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":24.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":58.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":132.23,"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":74.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":117.35,"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":48.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.42,"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":30.15,"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":"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":"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":"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":"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":"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":"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":"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":19.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":24.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":33.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":115.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":52.37,"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":35.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":18.6,"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":"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":"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":"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":"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":"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":208.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":158.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":230.03,"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":"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":15.17,"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":6.39,"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":"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":"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":"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":3.2,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":45.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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"]},{"negotiated_type":"negotiated","negotiated_rate":93.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":146.78,"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":238.57,"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":[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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":25.23,"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":"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":"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":"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":"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":32.18,"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":"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":"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":21.88,"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":28.99,"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":[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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":16.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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":[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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2312.34,"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":202.52,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15240","name":"Fth/gft f/c/c/m/n/ax/g/h/f20","description":"Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":223.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":72.97,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":191.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":22.49,"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":"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":"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":"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":"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":60.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":69.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":904.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":55.92,"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":32.06,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":216.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":8.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":73.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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"]}],"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":92.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":27.35,"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":52.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":75.74,"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":44.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":22.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":16.21,"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":"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":"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":"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":"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":"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":11.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":16.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":125.51,"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":326.06,"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":[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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":71.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":131.72,"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":270.89,"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":"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":"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":"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":619.57,"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":"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":"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":1040.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":50.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":90.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":89.24,"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":60.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-06","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.22,"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":216.02,"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":121.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":37.05,"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":"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":"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":"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":"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":"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":33.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":15.67,"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":"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":"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":27.0,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":92.23,"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":"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":96.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":10.61,"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":162.1,"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":136.19,"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":"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":"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":"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":"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":"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":91.64,"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":"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":"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":8.83,"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":335.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":584.21,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":117.62,"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":439.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":72.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":236.27,"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":"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":"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":63.89,"expiration_date":"9999-12-31","billing_class":"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","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":86.52,"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":459.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.0,"expiration_date":"9999-12-31","billing_class":"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":95.72,"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":"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":"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":"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":118.52,"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":206.72,"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":"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":"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":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":37.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.5,"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":"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":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"]},{"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":"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":"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":"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":"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":"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":"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":314.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":49.77,"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":66.19,"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":215.52,"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":645.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":50.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":541.64,"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":"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":"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":"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":36.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":41.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":257.1,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":77.92,"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":129.8,"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":"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":"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":"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":"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":"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":"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":"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":26.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.79,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":318.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":34.85,"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":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":"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":27.02,"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":54.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":117.92,"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":306.91,"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":"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":"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":"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":58.55,"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":"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":58.3,"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":310.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":70.32,"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":140.79,"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":70.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":70.71,"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":130.82,"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":"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":"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":257.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":172.17,"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":1897.06,"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":"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":"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":63.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":706.17,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":137.87,"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":1443.98,"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":[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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":94.59,"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":33.42,"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":[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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.17,"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":34.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"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":"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":"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":"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":"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":"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":85.09,"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":118.64,"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":"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":"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":123.18,"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":69.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27648","name":"Injection for ankle x-ray","description":"Injection procedure for ankle arthrography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":79.94,"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":43.81,"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":"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":"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":"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":"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":62.44,"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":875.48,"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":"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":"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":59.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":75.74,"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":44.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"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":"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":"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":188.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":86.52,"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":"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":62.11,"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":41.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2312.34,"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":202.52,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":42.32,"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":6.75,"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":16.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":139.37,"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"1329204","zip":"11004","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":28.2,"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":[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","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":9.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":34.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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"]}],"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":157.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":58.57,"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":30.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":22.43,"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":"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":10.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":115.1,"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":226.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.86,"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":"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":"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":8.66,"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":"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":"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":"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":"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":"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":"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":24.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":1416.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":105.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":172.12,"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":141.42,"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":"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":"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":1633.49,"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":"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":"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":31.13,"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":35.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.28,"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":536.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":81.26,"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":"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":"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":"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":"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":"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":"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":101.45,"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":"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":"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":"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":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":"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":"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":"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":"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":"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":72.65,"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":23.87,"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":"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":"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":"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":"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":"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":18.34,"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":"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":"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":"negotiated","negotiated_rate":39.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":54.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":16.51,"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":8.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":8.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":66.59,"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":33.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","locality":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":14.93,"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":"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":1733.78,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":40.97,"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":"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":"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":"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":"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":"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":"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":59.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":586.36,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.28,"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":64.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":"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":320.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":3949.58,"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":"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":"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":"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":"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":"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":11.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":40.46,"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":49.27,"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":"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":"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":232.87,"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":"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":"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":"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":"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":"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":"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":"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":89.76,"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":138.91,"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":97.64,"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":"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":"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":"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":"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":"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":19.91,"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":"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":"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":84.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":395.15,"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":323.66,"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":195.94,"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":"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":39.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":8.9,"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":13.04,"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":"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":"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":"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":"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":"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":"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":92.31,"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":72.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.35,"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":52.67,"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":"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":"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":"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":5.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":268.54,"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":"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":"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":"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":14.34,"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":10.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":48.97,"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":"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":"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":"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":"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":"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":"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":"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":"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":300.99,"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":241.49,"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":"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":30.56,"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":26.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":74.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":65.57,"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":111.92,"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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.67,"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":"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":"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":"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":"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":177.44,"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":791.85,"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":[4]}]},{"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":"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":"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":"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":"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":904.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":35.72,"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":70.64,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6221","name":"Gauze > 48 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":6.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.07,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":92.04,"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":28.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":101.9,"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":"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":"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":"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":"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":"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":301.41,"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":15.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":2580.38,"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":183.86,"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":"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":694.52,"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":"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":"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":"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":"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":27.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":34.25,"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":"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":"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":"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":"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":8.66,"expiration_date":"9999-12-31","billing_class":"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":2039.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":126.33,"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":"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":"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":"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":"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":16.09,"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":21.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":75.22,"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":192.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":146.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":905.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1424.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":86.52,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":66.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":977.16,"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":"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":"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":"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":"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":"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":"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":"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":"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":1328.71,"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":"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":"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":"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":100.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3034.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":60.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":41.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":117.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":558.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":51.5,"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":"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":"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":"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":"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":"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":"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":"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":"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":22.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":418.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2115.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1438.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":167.33,"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":263.09,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.47,"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":22.32,"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":"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":"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":"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":5.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":35.24,"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":"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":"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":"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":"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":"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":788.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":297.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":770.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":94.37,"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":157.83,"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":"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":"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":58.79,"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":"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":994.78,"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":[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","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2192.81,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":58.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.13,"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":"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":"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":"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":"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":"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":"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":11.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":194.6,"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":111.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.71,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.18,"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":22.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":25.49,"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":"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":"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":"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":"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":28.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":64.61,"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":"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":"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":"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":"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":"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":26.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":130.05,"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":17.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":33.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":151.46,"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":"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":44.46,"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":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":[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":"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":"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":"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":"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":"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":"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":"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":"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":15.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":72.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":17.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":23.03,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":902.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":88.22,"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":148.01,"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":[3]}]},{"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":"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":"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":"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":"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":64.5,"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":"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":"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":"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":"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":"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":36.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":56.89,"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":46.41,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":62.51,"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":"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":"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":"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":14.7,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"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":"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":"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":"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":"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":"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":"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":"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":113.12,"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":88.1,"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":47.24,"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":93.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.24,"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":48.68,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":190.76,"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":103.49,"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":1511.96,"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":"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":"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":"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":"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":"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":"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":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"]},{"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":[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","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":79.97,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1256.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":927.7,"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":"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":"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":"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":"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":78.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":87.54,"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":44.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2035.28,"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":"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":"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":"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":12.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":66.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.37,"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":"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":"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":"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":"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":"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":11.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":52.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":75.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":70.71,"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":142.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.48,"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":"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":"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","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":"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":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"]},{"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"]}],"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.83,"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":"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":"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":"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":"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":84.25,"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":113.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.03,"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":"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":"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":"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":2391.14,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":61.04,"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":89.17,"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":[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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":148.76,"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":232.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":68.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":114.91,"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":"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":"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":"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":"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":"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":"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":"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":768.42,"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":"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":"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":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":41.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":127.46,"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":"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":"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":120.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":3224.73,"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":[1]}]},{"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":"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":"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":"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":"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":"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":5.9,"expiration_date":"9999-12-31","billing_class":"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","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":"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":"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":114.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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]}]},{"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":"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":"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":67.0,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":41.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":28.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":54.74,"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":98.23,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":89.19,"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":"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":42.12,"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":54.35,"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":"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":"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":2017.26,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":505.5,"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":345.98,"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":[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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":51.77,"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":53.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":124.75,"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":"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":302.39,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":109.73,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":85.29,"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":"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":"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":"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":"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":117.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.56,"expiration_date":"9999-12-31","billing_class":"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","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.93,"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":"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":"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":"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":117.45,"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":185.75,"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":"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":"negotiated","negotiated_rate":51.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":883.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":48.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-06","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.08,"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":"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":"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":"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":"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":"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":"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":148.31,"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":"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":41.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":66.23,"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":"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":"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":1491.96,"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":"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":"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":"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":96.01,"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":53.51,"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":"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":"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":"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":"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":"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":"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":"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":18.72,"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":"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":"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":"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":"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":35.18,"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":"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":"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":"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":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":"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":65.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":943.45,"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":"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":"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":36.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2580.38,"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":183.86,"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":"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":"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":"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":"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":"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":"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":"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":31.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":83.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":173.52,"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":"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":"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":391.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":419.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":113.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":164.58,"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":55.78,"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":17.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":329.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":246.18,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":21.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":34.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":366.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":40.16,"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":94.91,"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":"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":25.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1771.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":58.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":34.3,"expiration_date":"9999-12-31","billing_class":"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"H2018","name":"Psysoc rehab svc, per diem","description":"Psychosocial rehabilitation services, per diem","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HE"]}],"provider_references":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":14.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":15.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":243.43,"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":151.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":88.49,"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":"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":"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":"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":52.05,"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":"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":"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":"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":"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":"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":"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":"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":74.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":33.88,"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":17.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":276.14,"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":3242.81,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.79,"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":324.92,"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":"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":"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":18.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":48.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":22.49,"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":"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":"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":"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":"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":94.68,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.93,"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":16.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":193.76,"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":"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":"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":"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":"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":"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":63.18,"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":"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":"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":"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":24.08,"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":18.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"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":"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":"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":4.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":44.09,"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":"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":"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":"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":"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":"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":"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":"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":"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":40.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":143.92,"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":72.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":233.95,"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":"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":35.72,"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":78.35,"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":"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":"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":636.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":27.98,"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":16.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":281.42,"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":158.41,"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":"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":"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":"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":"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":"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":18.73,"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":51.37,"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":[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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":48.95,"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":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"]}],"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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":104.81,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.69,"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":"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":"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":"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":"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":"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":449.82,"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":158.15,"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":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":97.05,"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":53.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.5,"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":33.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":167.03,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":39.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.8,"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":"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":"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":9.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.56,"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":101.39,"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":188.15,"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":"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":"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":"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":"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":"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":197.87,"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":116.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":117.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":50.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":24.01,"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":17.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77768","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.91,"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":48.92,"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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1148.03,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.35,"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":116.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1164.62,"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":"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":"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":59.45,"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":34.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":118.5,"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":73.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":1511.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":224.81,"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":"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":"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":510.5,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":63.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":290.5,"expiration_date":"9999-12-31","billing_class":"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","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.46,"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":"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":"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":"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":"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":"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":"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":"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":"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":218.3,"expiration_date":"9999-12-31","billing_class":"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","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":39.62,"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":25.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":283.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":122.85,"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":"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":"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":"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":"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":"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":"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":"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":338.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":27.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.8,"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":"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":"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":"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":"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":"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":"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":115.22,"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":2044.41,"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":[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":"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":"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":"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":1632.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.78,"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":"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":"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":"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":"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":34.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"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"]}],"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":84.25,"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":113.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":350.96,"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":18.44,"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":"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":851.4,"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":"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":"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":126.33,"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":41.72,"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":"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":"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":"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":328.73,"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":4041.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":76.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1083.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":88.51,"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":"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":"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":"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":"negotiated","negotiated_rate":63.88,"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":"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":191.51,"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":"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":"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":"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":"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":12.98,"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":"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":586.36,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":6.07,"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":"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":"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":59.83,"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":"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":"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":"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":"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":"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":184.44,"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":113.52,"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":"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":"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":"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":82.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":68.21,"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":"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":"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":"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":"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":19.79,"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":14.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":98.23,"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":54.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":89.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"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":"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":"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":"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":"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":"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":2080.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":358.02,"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":"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":"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":1136.93,"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":89.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":114.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":13.98,"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":"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":"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":"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":"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":"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":36.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":124.46,"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":157.79,"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":"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":"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":"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":"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":"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":"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":"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":162.62,"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":60.35,"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":["23","41","21","26","66","52","02","42","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":"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":"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":"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":"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":"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":34.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":64.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":249.83,"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":"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":"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":"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":"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":"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":"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":"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":57.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":104.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":57.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":117.62,"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":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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-06","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":285.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":89.15,"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":"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":"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":"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":"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":"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":1598.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.6,"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":51.34,"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":"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":26.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":51.63,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4009.22,"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":318.05,"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":"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":"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":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":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"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.15,"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":"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":"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":59.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":131.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":54.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":239.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":16.28,"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":"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":"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":"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":"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":63.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":53.49,"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":155.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":52.51,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.87,"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":15.4,"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":"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":"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":"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":"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":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.65,"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":15.97,"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":"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":"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":"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":"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":"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":"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":75.75,"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":31.73,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.46,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":16.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":22.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":69.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":139.43,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.89,"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":90.75,"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":"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":"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":18.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":37.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":31.9,"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":"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":"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":"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":106.7,"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":185.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":75.35,"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":52.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":125.1,"expiration_date":"9999-12-31","billing_class":"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":996.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":169.79,"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":81.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.23,"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":"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":29.95,"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":"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":"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":"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":"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":"negotiated","negotiated_rate":501.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":761.23,"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":55.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1160.86,"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":"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":"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":"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":"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":48.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":106.55,"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":"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":"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":"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":"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":"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":1180.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":97.59,"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":"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":"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":33.46,"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":21.8,"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":"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":"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":"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":371.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.4,"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":"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":"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":"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":"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":"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":"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":27.4,"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":"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":"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":"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":"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":"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":54.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.23,"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":"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":"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":"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":"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":108.71,"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":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":[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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1089.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.27,"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":"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":"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":"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":34.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":20.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":131.24,"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":112.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.07,"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":30.35,"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":83.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1988.09,"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":"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":"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":"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":"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":1851.67,"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":"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":"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":"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":22.68,"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":40.29,"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":"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":9.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":167.03,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":920.11,"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":621.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":270.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2203.61,"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":121.14,"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":[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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":137.24,"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":537.86,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":12.39,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":176.4,"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":"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":"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":"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":"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":189.47,"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":148.71,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":323.66,"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":395.15,"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":"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":"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":"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":"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":"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":22.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":62.51,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":58.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2032.78,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":32.78,"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":48.42,"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":[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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.58,"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":"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":"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":"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":"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":943.45,"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":65.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"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":"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":"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":"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":27.38,"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":"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":"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":"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":"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":26.33,"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":"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":298.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1088.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":105.44,"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":32.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":224.42,"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":1000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":185.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":82.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":247.45,"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":"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":"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":4.85,"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":"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":45.96,"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":"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":"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":"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":"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":26.01,"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":"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":"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":1089.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":123.18,"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":67.5,"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":"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":"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":"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":"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":"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":"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":20.3,"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":"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":"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":"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":59.13,"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":"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":"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":"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":"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":"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":154.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1841.51,"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":"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":"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":"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":"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":"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":"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":4.37,"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":"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":"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":"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":"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":"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":"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":173.49,"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":2431.84,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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","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":"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":134.85,"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":47.63,"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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-06","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.22,"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":"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":"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":"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":"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":"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":"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":"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":15.89,"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":"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":"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":"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":26.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.64,"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":48.18,"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":[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","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":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"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":74.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":["AU","AV"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":312.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.13,"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":"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":"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":"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":"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":98.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":135.32,"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":236.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.28,"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":"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":"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":"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":1180.49,"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":112.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":30.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":58.57,"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":"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":"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":163.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":261.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":781.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.73,"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":75.75,"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":"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":"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":"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":"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":"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":46.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":45.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":13.01,"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":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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-06","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":66.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":60.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":88.57,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"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":"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":135.67,"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":87.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21390","name":"Opn tx orbit periorbtl implt","description":"Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":41.18,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":314.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":229.47,"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":116.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":267.88,"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":"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":"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":"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":"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":12.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.04,"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":"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":85.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":353.78,"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":19.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.0,"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":"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":"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":"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":133.58,"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":27.92,"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":88.98,"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":17.81,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.59,"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":16.34,"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":"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":"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":"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":"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":"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":"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":"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":75.42,"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":"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":"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":"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":"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":"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":"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":"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":4.58,"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":1.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":3.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.73,"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":51.37,"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":[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","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":31.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":77.78,"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":160.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":468.74,"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":318.41,"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":"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":"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":"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":"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":"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":"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":"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":11.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.95,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":254.75,"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":"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":"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":"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":"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":"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":"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":"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":1318.62,"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":"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":"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":"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":1295.21,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":43.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":246.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":83.71,"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":"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":"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":"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":"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":"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":"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":"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":"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":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":11.45,"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":"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":"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":"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":"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":"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":"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":"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":1118.43,"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":173.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":39.87,"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":59.07,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":58.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1328.71,"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":"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":"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":214.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":731.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":43.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":79.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.1,"expiration_date":"9999-12-31","billing_class":"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":60.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":5.9,"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":"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":"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":"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":"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":"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":"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":"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":61.55,"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":"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":"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":"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":"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":557.03,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1951.04,"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":"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":"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":"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":147.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1199.84,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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":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"]}],"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":"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":"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":73.28,"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":28.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":49.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2884.97,"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":"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":"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":"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":59.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":30.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":57.49,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.13,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":16.09,"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":21.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":226.2,"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":127.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":105.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":71.66,"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":"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":"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":"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":"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":"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":"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":26.32,"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":"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":"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":"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":"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":82.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":19.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":90.67,"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":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"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":135.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":462.65,"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":"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":"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":83.9,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":14.7,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":61.02,"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":72.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.27,"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":"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":"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":256.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":64.3,"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":115.04,"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":[3]}]},{"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":"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":"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":"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":"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":191.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":14.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"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":"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":"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":"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":"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":"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":"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":186.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":269.97,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.3,"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":"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":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":122.41,"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":[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","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":22.49,"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":"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":"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":"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":"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":5.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":12.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1558.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.79,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":348.67,"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":"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":"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":"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":"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":"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":3724.05,"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":304.57,"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":"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":"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":34.07,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":77.95,"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":655.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":123.32,"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":197.09,"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":"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":22.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":32.09,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.83,"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":47.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":113.69,"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":46.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":124.46,"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":157.79,"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":"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":"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.04,"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":"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":"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":"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":7.1,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":191.51,"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":"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":"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":"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":"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":"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":"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":51.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":334.32,"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":129.1,"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":[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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":82.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":481.44,"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":"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":"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":"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":"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":"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":"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":715.87,"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":"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":"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":"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":198.62,"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":"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":1273.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43757","name":"Dx duod intub w/asp specs","description":"Duodenal intubation and aspiration, diagnostic, includes image guidance; collection of multiple fractional specimens with pancreatic or gallbladder stimulation, single or double lumen tube, includes drug administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":108.61,"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":267.44,"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":[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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":219.48,"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":"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":"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":"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":"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":"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":"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":"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":27.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":35.08,"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":"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":23.68,"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":"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":"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":"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":"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":"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":"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":29.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.95,"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":"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":"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":"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":32.3,"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":19.95,"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":"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":"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":"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":"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":"CPT","billing_code_type_version":"2026","billing_code":"47001","name":"Ndl biopsy lvr tm oth maj px","description":"Biopsy of liver, needle; when done for indicated purpose at time of other major procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":203.91,"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":946.86,"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":"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":6.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1598.7,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":959.9,"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":"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":"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":"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":86.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":48.68,"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":"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":"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":"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":5.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.25,"expiration_date":"9999-12-31","billing_class":"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":192.5,"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":"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":"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":7.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":39.21,"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":84.7,"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":"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":"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":"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":22.1,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":15.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":44.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":115.73,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":37.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":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"]}],"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":175.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":172.17,"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":1897.06,"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":"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":"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":118.79,"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":"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":"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":"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":8.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":65.93,"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":111.52,"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":"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":"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":"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":"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":"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":93.23,"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":47.24,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","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":"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":"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":"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":"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":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":1194.79,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":160.83,"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":"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":"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":"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":"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":6.64,"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":16.12,"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":"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":"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":"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":"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":"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":"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":235.66,"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":298.01,"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":"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":"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":"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":"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":"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":2180.73,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.82,"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":"99232","name":"Sbsq hosp ip/obs moderate 35","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minut","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":52.97,"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":28.54,"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":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":"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":"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":"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":"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":"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":"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":82.85,"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":128.11,"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":[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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":41.69,"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":"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":183.82,"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":"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":"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":"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":"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":93.41,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":45.08,"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":"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":"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":"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":"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":64.37,"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":"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":"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":"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":"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":"98960","name":"Edu&trn pt self-mgmt nqhp 1","description":"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; individual patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["U3","U1"]}],"provider_references":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":14.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":84.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":347.58,"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":"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":"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":"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":"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":"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":"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":"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":22.49,"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":"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":"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":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":14.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":336.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":40.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":57.57,"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":[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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":231.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":290.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":42.12,"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":54.35,"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":"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":"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":"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":"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":"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":1253.07,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":80.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":75.35,"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":"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":"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":"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":"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":"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":"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":55.29,"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":42.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.86,"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":"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":26.5,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":300.68,"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":374.7,"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.27,"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":"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":"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":"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":"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":"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":"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":119.87,"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":3277.46,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.79,"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":324.92,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":938.92,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":664.46,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2168.99,"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":121.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":80.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":142.73,"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":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":[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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":709.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":911.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":264.1,"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":"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":"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":"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":"negotiated","negotiated_rate":216.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":140.51,"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":119.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":68.48,"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":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":[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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":251.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":87.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":211.63,"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":107.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":73.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":261.91,"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":13.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":93.41,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":146.36,"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":231.34,"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":"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":"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":"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":"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":"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":"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":"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":632.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":113.26,"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":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":[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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1874.73,"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":"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":"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":"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":"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":20.73,"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":51.71,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":140.84,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":184.65,"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":98.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2296.43,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":35.08,"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":99.99,"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":"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":316.89,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.9,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":75.1,"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":916.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":183.88,"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":"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":"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":"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":"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":"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":"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":2986.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":258.43,"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":140.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":13.01,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27825","name":"Treat lower leg fracture","description":"Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; with skeletal traction and/or requiring manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1771.69,"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":"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":"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":"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":99.86,"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":118.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":208.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.28,"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":14.43,"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":"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":"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":"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":"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":"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":"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":"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":329.76,"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":125.75,"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":[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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.69,"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":"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":"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":"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":623.57,"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":"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":"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":15.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":282.79,"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":"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":"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":"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":"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":"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":28.67,"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":73.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1180.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":8.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":87.15,"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":"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":"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":"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":"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":"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":"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":132.05,"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":58.61,"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":744.56,"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":504.44,"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":"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":"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":"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":"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":"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":22.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[4]}]},{"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":"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":"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":"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":26.32,"expiration_date":"9999-12-31","billing_class":"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","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"],"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","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":186.72,"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":46.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":30.53,"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":"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":"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":"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":"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":"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":26.87,"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":18.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.46,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.03,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":170.99,"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":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":[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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":90.9,"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":"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":118.1,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":92.04,"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":28.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.37,"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":"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":"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":"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":91.39,"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":36.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":210.54,"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":"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":"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":"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":40.29,"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":22.68,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":34.11,"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":"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":"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":1051.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":485.91,"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":"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":"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":33.47,"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":"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":"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":"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":"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":"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":"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":"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":60.56,"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":"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":19.79,"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":"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":"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":"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":31.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":391.32,"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":"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":"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":6.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":55.63,"expiration_date":"9999-12-31","billing_class":"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","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":328.73,"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":4041.76,"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":"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":158.41,"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":281.42,"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":"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":"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":"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":"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":"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":52.02,"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":28.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":113.12,"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":88.1,"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":[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":22.43,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.55,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":39.8,"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":"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":"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":"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":255.08,"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":137.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":96.6,"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":48.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":90.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":20.3,"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":"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":39.08,"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":24.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.46,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.08,"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":"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":"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":24.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":8.66,"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":"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":"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":"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":"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":4.85,"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":"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":"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":"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":"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":1733.78,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"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":"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":632.48,"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":"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":"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":"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":"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":134.78,"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":60.91,"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":[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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":454.92,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":117.62,"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":439.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":185.99,"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":224.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":856.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":163.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":148.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":64.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.35,"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":21.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":113.8,"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":224.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":140.83,"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":250.09,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":91.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":135.5,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.07,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":37.25,"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":"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":"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":"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":"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":"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":"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":325.54,"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":17.5,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":110.1,"expiration_date":"9999-12-31","billing_class":"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":87.54,"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":44.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":143.2,"expiration_date":"9999-12-31","billing_class":"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","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":"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":"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":"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":"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":"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":"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":"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":83.9,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":52.08,"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":153.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":30.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":102.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.44,"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":32.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":66.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":928.82,"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":19.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":171.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":2115.89,"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":"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":"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":"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":"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":"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":"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":2810.82,"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":"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":"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":"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":"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":"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":"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":98.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":99.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":64.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":90.04,"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":146.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":41.03,"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":23.18,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.97,"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":6.65,"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":"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":"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":"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":23.68,"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":"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":"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":148.28,"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":423.14,"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":[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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":70.64,"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":35.72,"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":495.34,"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":"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":"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":"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":"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":"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":"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":25.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":38.01,"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":"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":"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":"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":"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":101.16,"expiration_date":"9999-12-31","billing_class":"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":10.51,"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":"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":1.69,"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":"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":"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":"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":52.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":72.92,"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":143.07,"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":"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":"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":"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":"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":4.85,"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":"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":"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":584.21,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":116.84,"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":"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":"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":"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":"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":"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":135.67,"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":87.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":126.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":148.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":3.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":125.51,"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":326.06,"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":[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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-06-06","zip":"10985","rural":"Y","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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":12.63,"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":"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":"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":"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":"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":1.37,"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":4.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":5.54,"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":113.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":164.58,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":80.54,"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":"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":"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":67.0,"expiration_date":"9999-12-31","billing_class":"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":62.11,"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":38.52,"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":"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":"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":"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":"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":"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":126.71,"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":68.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":874.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":213.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":252.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":23.35,"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":"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":"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":114.47,"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":53.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21195","name":"Reconst lwr jaw w/o fixation","description":"Reconstruction of mandibular rami and/or body, sagittal split; without internal rigid fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":115.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":17.57,"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":25.52,"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":"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":"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":"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":"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":"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":"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":27.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":87.87,"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":"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":"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":"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":"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":"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":"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":296.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":16.51,"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":8.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93644","name":"Ep eval subq impl dfb","description":"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":16.12,"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":6.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":948.95,"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":"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":"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":"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":2155.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":93.92,"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":110.92,"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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":27.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":72.35,"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":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"]}],"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.1,"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":"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":"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":"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":"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":"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":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":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"]}],"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":869.13,"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":"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":"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":"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":"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":"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":104.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":630.23,"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":1170.89,"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":"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":"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":"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":"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":"negotiated","negotiated_rate":14.87,"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":"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":"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":"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":"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":"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":21.04,"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":27.35,"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":"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":"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":"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":"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":"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":"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":21.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":44.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":100.34,"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":56.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":185.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":95.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":869.13,"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":"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":"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":"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":4.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":67.56,"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":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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":187.72,"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":91.16,"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":"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":"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":"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":"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":"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":"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":"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":"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":58.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":132.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":130.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":402.71,"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":[1]}]},{"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":"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":"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":29.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.8,"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":"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":52.82,"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":65.63,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":66.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":52.92,"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":"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":"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":"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":"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":"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":1120.75,"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":91.46,"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":"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":"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":"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":"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":"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":"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":"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":"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":7.1,"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":"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":2068.32,"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":"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":"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":3.56,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":357.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":33.83,"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":29.72,"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":[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":"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":"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":78.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.11,"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":"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":"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":113.33,"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":1182.24,"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":"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":"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":"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":"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":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":"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":"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":130.62,"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":"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":"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":"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":27.88,"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":"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":"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":"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":"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":"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":"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":"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":102.64,"expiration_date":"9999-12-31","billing_class":"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","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":182.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":264.1,"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":"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":"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":"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":"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":"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":2.69,"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":"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":3.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.27,"expiration_date":"9999-12-31","billing_class":"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":167.4,"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":"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":"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":"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":"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":"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":"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":"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":6.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":20.3,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":102.11,"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":120.88,"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":44.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":61.52,"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":"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":"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":"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":"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":"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":"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":"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":38.48,"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":"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":"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":13.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":120.27,"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":270.91,"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":82.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1180.49,"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":112.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":123.47,"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":3299.77,"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":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":"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":22.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":510.5,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":21.04,"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":27.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.27,"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":"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":"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":"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":"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":"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":"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":2.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":49.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":742.3,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2080.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":55.78,"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":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":178.22,"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":215.76,"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":[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":"10301","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":[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","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":115.22,"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":"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":"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":"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":"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":6.42,"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":"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":"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":"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":79.74,"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":41.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":61.73,"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":125.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":232.31,"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":148.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1204.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.66,"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":54.02,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.5,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-06","zip":"10301","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":[7]}]},{"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":"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":349.48,"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":280.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":196.14,"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":253.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.23,"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":"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":"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":"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":"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":"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":"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":47.2,"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":37.21,"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":"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":"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":"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":114.54,"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":47.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":13.57,"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":241.72,"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":"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":"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":"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":"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":"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":223.7,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":91.89,"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":"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":"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":6.07,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.84,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":84.24,"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":36.93,"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":"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":"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":"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":"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":"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":"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":"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":60.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":141.32,"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":248.72,"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":"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":"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":"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":"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":"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":"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":36.02,"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":"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":"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":"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":"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":1632.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":76.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":96.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":124.04,"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":211.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":4.85,"expiration_date":"9999-12-31","billing_class":"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.36,"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":5.43,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":170.96,"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":"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":"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":"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":"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":256.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2203.61,"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":121.14,"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":[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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.67,"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":"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":"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":26.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":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":"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":"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":"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":44.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":164.42,"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":199.8,"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":[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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":39.08,"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":24.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":55.38,"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":117.55,"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":207.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.28,"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":"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":"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":"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":"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":"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":"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":"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":34.49,"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":51.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":184.44,"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":113.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":68.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":73.99,"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":609.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.13,"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":"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":"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":"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":"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":63.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":94.59,"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":"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":"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":"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":"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":"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":"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":358.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":65.63,"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":52.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":64.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":236.1,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":63.02,"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":"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":"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":"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":"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":"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":1438.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":337.79,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":233.01,"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":365.09,"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":"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":"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":"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":"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":"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":134.64,"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":95.96,"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":"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":"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":"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":"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":"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":"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":135.45,"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":1464.05,"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":"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":"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":"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":"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":30.19,"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":"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":134.85,"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":47.63,"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":[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","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":"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":"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":32.06,"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":55.92,"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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.33,"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":81.07,"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":[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":"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":"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":"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":"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":"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":16.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.63,"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":"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":"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":"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":"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":"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":20.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":34.79,"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":"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":"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":"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":"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":"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":"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":14.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":26.66,"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":18.21,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":179.47,"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":2278.81,"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":[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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":22.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":80.09,"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":"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":"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":291.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":56.96,"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":"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":"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":"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":3242.81,"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":276.14,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":296.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":153.55,"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":38.6,"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":"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":"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":40.97,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":91.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":110.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.5,"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":"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":"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":"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":"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":"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":"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":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.83,"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":24.49,"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":"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":98.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":175.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":210.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.69,"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":"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":"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":"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":"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":20.3,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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":"1320203","zip":"10512","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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.46,"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":"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":"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":"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":37.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":53.24,"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":30.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":36.67,"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":"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":6.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":24.56,"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":"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":"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":"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":77.88,"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":130.82,"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":"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":"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":"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":31.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":860.7,"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":583.93,"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":"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":"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":11.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.39,"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":143.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":55.67,"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":118.52,"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":22.79,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":12.4,"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":"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":31.04,"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","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":35.24,"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":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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":42.77,"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":143.78,"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":"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":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"]},{"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"]}],"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":198.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":143.36,"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":1479.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":300.99,"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":241.49,"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":"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":"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":"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":"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":377.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":20.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":89.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":1136.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":102.44,"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":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"]}],"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","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":"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":"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":193.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":50.48,"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":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"]}],"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":55.36,"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":"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":"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":"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":"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":"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":236.74,"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":91.06,"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":"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":"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":"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":"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":"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":80.21,"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":86.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":114.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1141.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":99.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":32.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":56.42,"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":45.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2114.7,"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":155.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":52.71,"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":65.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.36,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":124.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":71.36,"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":130.46,"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":"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":52.08,"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":153.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":165.05,"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":138.54,"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":"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":"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":"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":"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":"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":12.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":25.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2541.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":47.03,"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":80.51,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1040.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":377.11,"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":"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":"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":"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":"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":"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":"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":"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":3.22,"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":"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":"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":"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":664.27,"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":1247.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":91.9,"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":"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":"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":"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":"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":"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":"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":"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":189.89,"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":"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":"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":"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":"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":7.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.36,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.85,"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":"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":"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":"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":"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":27.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":183.95,"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":802.0,"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":"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":"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":"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":"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":176.4,"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":"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":"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":"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":"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":"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":"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":"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":2.85,"expiration_date":"9999-12-31","billing_class":"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","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":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":11.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1142.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1072.58,"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":"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":"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":"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":"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":"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":25.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":737.77,"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":168.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":145.6,"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":62.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":65.48,"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":"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":"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":"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":"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":36.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":99.11,"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":51.16,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":58.79,"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":"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":"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":"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":"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":"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":"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":"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":"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":120.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":100.14,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":16.39,"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":27.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":115.22,"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":"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":"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":"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":"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":"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":"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":9.84,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":50.52,"expiration_date":"9999-12-31","billing_class":"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":"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":377.3,"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":304.53,"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":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":17.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":94.04,"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":135.69,"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":"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":"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":"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":"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":"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":94.59,"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":33.42,"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":[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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.45,"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":43.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":68.88,"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":58.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":49.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":30.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":78.14,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":62.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":36.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.78,"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":"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":"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":"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":7.1,"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":"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":"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":"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":"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":62.45,"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":"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":"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":"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":"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":2026.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":706.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":268.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":71.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":130.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":115.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":432.41,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":15.61,"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":"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":"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":4.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1170.53,"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":"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":"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":"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":"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":"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":"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":"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":"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":100.14,"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":"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":1019.45,"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":"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":"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":"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":5.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":22.32,"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":29.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.89,"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":72.47,"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":36.73,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":102.06,"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":66.68,"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":[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":"1328299","zip":"12007","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":670.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":665.93,"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":"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":"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":141.71,"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":88.14,"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":"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":"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":"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":"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":"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":"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":172.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.76,"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":"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":"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":"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":"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":"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":"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":"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":6.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":34.39,"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":21.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":95.96,"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":134.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":50.03,"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":"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":"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":"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":"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":"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":"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":"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":"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":26.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":51.63,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":58.62,"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":"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":"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":66.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":135.95,"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":162.3,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":670.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.08,"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":"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":"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":"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":"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":"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":"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":"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":64.43,"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":25.41,"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":"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":"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":"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":"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":22.57,"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":332.54,"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":"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":"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":"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":"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":156.47,"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":797.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":995.33,"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":"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":"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":"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":"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":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":"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":"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":22.32,"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":29.18,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.55,"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":"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":"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":32.81,"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":"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":275.82,"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":153.53,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":34.25,"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":697.41,"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":"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":"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":"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":"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":137.09,"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":"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":"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":62.16,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":17.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":243.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.65,"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":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"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":"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":"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":"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":"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":38.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":68.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":134.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":22.57,"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":45.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.61,"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":"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":"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":"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":"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":38.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":124.13,"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":"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":83.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2192.81,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.37,"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":"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":"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":"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":"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":"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":"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":"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":64.03,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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":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":"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":52.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":490.29,"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":8.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":68.2,"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":137.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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","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":"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":"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":"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":5.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":123.18,"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":69.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.21,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":99.26,"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":204.11,"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":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":"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":"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":"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":"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":"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":"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":12.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":150.9,"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":70.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":234.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":875.39,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.1,"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":"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":"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":"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":"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":74.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":39.29,"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":"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":"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":"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":178.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":293.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":32.03,"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":24.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":100.4,"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":"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":"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":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"]},{"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"]}],"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1446.89,"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":"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":"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":"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":"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":505.5,"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":345.98,"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":[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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":21.8,"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":33.46,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":134.22,"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":79.41,"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":154.83,"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":130.42,"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":[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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":42.78,"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":55.29,"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":"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":"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":"negotiated","negotiated_rate":333.52,"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":"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":"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":"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":"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":"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":"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":"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":18.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":135.5,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.87,"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":"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":"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":"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":"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":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"T1015","name":"Clinic service","description":"Clinic visit/encounter, all-inclusive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HE"]}],"provider_references":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":950.56,"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":67.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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":"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":"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":"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":"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":24.96,"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":481.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":116.3,"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":97.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":37.1,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1397.69,"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":97.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":132.05,"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":58.61,"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":[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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":28.21,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.2,"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":17.51,"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":"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":"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":"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":"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":"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":"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":18.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":24.53,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1750.94,"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":"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":5.83,"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":"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":85.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":32.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":379.82,"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":123.08,"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":"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":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":"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":"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":"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":"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":"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":17.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":42.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.03,"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":"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":82.12,"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":"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":"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":"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":"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":"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":"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":"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":84.14,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2541.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":1397.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":47.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":121.57,"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":[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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.71,"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":20.73,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":76.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":19.77,"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":"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":"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":"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":"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":"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":"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":"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":57.3,"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":49.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":61.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3039.57,"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":114.38,"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":"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":"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":"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":"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":"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":"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":57.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":34.79,"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":20.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":52.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.34,"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":"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":"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":"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":"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":"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":88.98,"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":27.92,"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":"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":"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":"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":"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":12.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":81.06,"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":41.09,"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":22.74,"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":[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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":18.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.28,"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":"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":"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":13.49,"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":5.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":148.55,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":235.58,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":30.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":52.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":68.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":45.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":62.8,"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":"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":"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":"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":"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":171.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":2115.89,"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":"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":"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":"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":"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":"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":"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":66.29,"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":"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":"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":58.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":84.83,"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":"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":"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":214.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"negotiated","negotiated_rate":1274.45,"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":"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":"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":53.49,"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":155.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.71,"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":"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":"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":"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":"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":494.38,"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":"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":"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":"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":"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":"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":32.09,"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":5.83,"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":"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":"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":"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":"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":"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":15.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":920.0,"expiration_date":"9999-12-31","billing_class":"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":"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":52.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":82.59,"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":"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":"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":"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":"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":15.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":44.36,"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":"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":"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":"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":"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":"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":"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":62.8,"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":"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":"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":"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":"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":9.9,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":255.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":136.97,"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":83.06,"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":"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":"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":"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":29.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.68,"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":51.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":170.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":39.24,"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":"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":"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":"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":"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":37.06,"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":"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":"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":141.32,"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":248.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":16.44,"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":"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":"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":"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":"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":694.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":224.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":100.61,"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":85.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":113.26,"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":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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":181.59,"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":131.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1131.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":60.49,"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":81.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":90.58,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":289.41,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":357.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":655.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.4,"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.35,"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":"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":57.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":63.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":147.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.5,"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":"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":"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":"negotiated","negotiated_rate":18.4,"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":"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":"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":731.52,"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":"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":"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":"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":"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":"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":2673.02,"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":"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":"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":"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":"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":3.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1164.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":21.59,"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":"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":"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":"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":"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":"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":"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":"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":248.55,"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":"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":"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":"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":"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":26.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":67.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":111.0,"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":"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":"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":"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":"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":"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":859.39,"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":"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":"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":"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":"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":"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":"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":1063.17,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":388.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":104.39,"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":"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":"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":8.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":157.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":118.58,"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":102.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":73.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":37.79,"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":49.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":92.9,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":715.87,"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":"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":"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":"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":106.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":76.93,"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":"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":"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":"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":"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":"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":"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":"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":301.56,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1131.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":64.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":198.79,"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":118.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":299.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.63,"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":"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":"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":"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":"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":"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":162.21,"expiration_date":"9999-12-31","billing_class":"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":293.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1951.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":1901.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.93,"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":"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":"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":"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":"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":"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":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":74.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":70.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":150.9,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":788.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":928.82,"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":66.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50610","name":"Removal of ureter stone","description":"Ureterolithotomy; upper one-third of ureter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":4.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":291.95,"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":119.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":41.18,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":69.29,"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":119.33,"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":[4]}]},{"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":"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":"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":"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":"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":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":41.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":160.49,"expiration_date":"9999-12-31","billing_class":"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":75.71,"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":42.24,"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":"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":"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":87.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":141.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":22.82,"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":16.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":"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":"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":"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":"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":"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":146.36,"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":231.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":123.47,"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":3299.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":166.51,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":130.01,"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":368.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.46,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.16,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":43.83,"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":53.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.12,"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":18.5,"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":"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":310.49,"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":136.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":83.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1841.51,"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":154.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":27.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.95,"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":40.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","locality":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":115.22,"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":2044.41,"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":[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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":174.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":88.14,"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":141.71,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-06","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_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":"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":"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":"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":"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":"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":26.5,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":54.48,"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":73.14,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":1838.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":76.77,"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":"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":"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":"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":"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":148.71,"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":189.47,"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":"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":"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":286.07,"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":114.63,"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":[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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":142.82,"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":70.71,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":431.9,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":661.4,"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":80.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":71.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[1]}]},{"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":"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":"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":"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":"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":"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":5.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":182.34,"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":2620.13,"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.64,"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":48.18,"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":[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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":8.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":62.94,"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":141.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":184.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.48,"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":"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":15.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2323.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":46.69,"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":122.19,"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":7.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.38,"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":8.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":31.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":802.0,"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":129.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":183.95,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":33.81,"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":59.57,"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.95,"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":"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":26.33,"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.9,"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":"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":"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":"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":"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":"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":"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":120.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":3224.73,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24430","name":"Rpr non/mal humerus wo graft","description":"Repair of nonunion or malunion, humerus; without graft (eg, compression technique)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":54.35,"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":42.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":35.21,"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":61.13,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":93.92,"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":110.92,"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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":37.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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"]}],"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":"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":98.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":133.74,"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":412.53,"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":"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":"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":"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":114.03,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":116.24,"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":"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":41.69,"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":"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":"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":"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":"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":"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":34.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":59.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":102.44,"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":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"]}],"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":236.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.68,"expiration_date":"9999-12-31","billing_class":"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":16.28,"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":6.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":35.38,"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":48.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":79.97,"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":"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":"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":"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":25.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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":[3]}]},{"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":"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":26.5,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":8.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":28.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":52.02,"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":"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":"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":"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":39.82,"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":22.06,"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":"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":"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":"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":"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":"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":519.74,"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":"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":"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":"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":46.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":51.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.45,"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":"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":"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":"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":"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":62.04,"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":73.36,"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":23.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":56.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":234.11,"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":"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":"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":"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":"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":"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":"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":59.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":105.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1760.51,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.32,"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":"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":"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":"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":"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":"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":27.01,"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":"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":"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":102.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":141.49,"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":"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":"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":"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":12.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.8,"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":"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":"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":"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":"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":"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":"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":425.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":239.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":83.17,"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":71.75,"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":"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":"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":"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":"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":"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":156.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":80.35,"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.43,"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":1.36,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":166.87,"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":337.79,"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":"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":9.93,"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":"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":"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":"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":"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":"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":29.95,"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":52.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.73,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":319.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":230.18,"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":"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":"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":"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":"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":"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":"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":68.26,"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":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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":226.43,"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":"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":"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":61.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.22,"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":"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":"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":"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":"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":"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":"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":"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":102.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.79,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1101.47,"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":"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":"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":"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":"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":"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":"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":15.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":"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":"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":82.31,"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":134.7,"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":[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","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":86.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":246.92,"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":"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":"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":"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":"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":650.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":62.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":96.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1447.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.5,"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":24.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":48.3,"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":"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":"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":"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":"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":"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":"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":"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":332.87,"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":145.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":185.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":417.18,"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":268.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":11.94,"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":"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":"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":"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":"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":"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":"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":125.09,"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":49.14,"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":49.6,"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.46,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":49.37,"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":27.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":238.57,"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":146.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1065.71,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":169.22,"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":117.1,"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":[2]}]},{"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":"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":"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":"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":"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":111.33,"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":86.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":80.51,"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":47.03,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":192.5,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":71.04,"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":413.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":82.53,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.91,"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":9.97,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":107.67,"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":211.63,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":173.18,"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":13.25,"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":9.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":32.81,"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":"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":"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":"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":"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":"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":203.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":16.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":18.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":72.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.93,"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.4,"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":"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":"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":"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":620.99,"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":"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":"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":"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":"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":"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":"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":"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":63.56,"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":"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":"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":"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":"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":"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":39.87,"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":59.07,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.69,"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":"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":233.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":55.67,"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":118.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":507.41,"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":"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":"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":"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":"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":"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":"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":43.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":89.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":342.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":48.86,"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":28.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":585.51,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1131.74,"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":181.59,"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":"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":"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":1876.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":54.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":91.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":114.02,"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":44.07,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.78,"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":"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":56.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":65.04,"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":[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":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":123.36,"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":74.21,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":574.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":60.49,"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":31.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":81.04,"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":"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":"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":"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":"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":118.79,"expiration_date":"9999-12-31","billing_class":"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.87,"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":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":19.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":97.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":132.58,"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":96.17,"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":"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":"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":"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":"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":"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":"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":140.4,"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":119.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":53.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":62.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1101.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":744.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.93,"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":15.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":130.33,"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":71.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62303","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":314.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":130.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":402.71,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97810","name":"Acup 1/> wo estim 1st 15 min","description":"Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":41.09,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":33.26,"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":51.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":28.67,"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":73.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":35.57,"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":31.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":102.11,"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":120.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":41.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":243.96,"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":314.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":180.32,"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":2244.14,"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":[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":"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":"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":"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":"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":"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":"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":"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":32.02,"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":"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":"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":"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":"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":39.2,"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":"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":"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":"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":"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":"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":"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":"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":18.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":1.69,"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":"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":"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":"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":"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":"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":"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":40.84,"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":24.41,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":43.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":994.78,"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":[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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.31,"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":"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":"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":"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":"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":"CPT","billing_code_type_version":"2026","billing_code":"53025","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":454.92,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.27,"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":"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":74.21,"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":123.36,"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":"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":"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":731.44,"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":"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":50.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":39.2,"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":"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":"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":25.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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":[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":"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":"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":"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":50.15,"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":"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":"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":"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":"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":11.12,"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":7.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":20.3,"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":"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":"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":"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":"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":25.68,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":998.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":153.05,"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":72.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.3,"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67210","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":14.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":362.27,"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":525.5,"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":619.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":261.91,"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":13.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"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":"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":"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":2.69,"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":"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":"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":90.81,"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":"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":"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":"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":"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":"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":"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":"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":"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":51.89,"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":114.37,"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1.55,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":391.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":17.6,"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":23.36,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":128.18,"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":1358.99,"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":"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":31.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":48.57,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":89.7,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.61,"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":228.02,"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":139.79,"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":[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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":77.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":81.06,"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":23.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":41.65,"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":"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":"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":"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":"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":"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":"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":74.25,"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":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":110.63,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":56.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":60.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3005.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":342.17,"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":"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":230.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.95,"expiration_date":"9999-12-31","billing_class":"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","zip":"13020","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":["QW"]}],"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":26.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":49.0,"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":26.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":40.62,"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":66.09,"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":"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":"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":"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":23.16,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":118.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":18.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1120.75,"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":91.46,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.95,"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":"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":"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":"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":432.41,"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":"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":"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":1163.3,"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":"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":"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":"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":"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":"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":"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":"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":"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":146.11,"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":330.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":23.98,"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":43.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":28.69,"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":21.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":78.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":122.85,"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":72.51,"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":"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":"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":"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":"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":"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":"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":"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":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":78.92,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":146.27,"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":"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":"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":"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":"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":"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":"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":"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":75.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-06","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":39.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":97.7,"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":162.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1182.24,"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":113.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.05,"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":"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":"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":"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":"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":"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":"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":"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":23.93,"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":17.24,"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":[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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":1262.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":30.24,"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":"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":"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":"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":"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":23.03,"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":17.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"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":"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":"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":148.27,"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":53.55,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.1,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":39.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":119.33,"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":69.29,"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":"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":"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":"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":"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":"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":6.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":693.06,"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":"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":48.4,"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":82.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.01,"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":"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":"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":"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":"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":"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":"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":319.85,"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":15.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":901.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":890.56,"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":"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":"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":"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":"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":"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":"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":39.21,"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":"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":"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":"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":"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":"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":129.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":576.07,"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":"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":"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":135.32,"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":236.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":238.23,"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":149.48,"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":126.21,"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":"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":"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":"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":"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":"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":"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":20.12,"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":"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":52.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":38.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":1105.94,"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":"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":"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":"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":71.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":149.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":3.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":93.43,"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":46.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":135.26,"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":40.08,"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":"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":1084.22,"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":"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":"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":"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":"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":783.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1131.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":59.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":68.03,"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":122.8,"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":[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":"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":"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":"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":"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":65.1,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":203.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":130.82,"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":77.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":246.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":89.17,"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":"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":28.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":51.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":34.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":189.05,"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":46.03,"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":[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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"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":1.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":595.22,"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":"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":"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":"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":148.76,"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":190.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":166.17,"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":263.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.72,"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":"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":"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":"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":"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":"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":2039.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":60.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":89.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":96.01,"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":53.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":82.64,"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":96.62,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-06-06","zip":"10985","rural":"Y","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1524.71,"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":"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":"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":"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":"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":"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":"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":29.81,"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":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":21.04,"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":27.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":57.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":86.03,"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":143.51,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":994.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":83.91,"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":48.42,"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":32.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":64.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":693.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1019.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.95,"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":"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":"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":"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":"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":"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":"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":"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":53.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":62.48,"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":"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":"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":"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":"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":"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":"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":51.31,"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":33.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":315.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.89,"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":90.75,"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":"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":"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":"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":"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":"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":"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":234.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":606.06,"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":"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":158.15,"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":449.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.13,"expiration_date":"9999-12-31","billing_class":"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","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":120.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":114.47,"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":53.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":7.76,"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":"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":"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":63.8,"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","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":["26"]}],"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":99.3,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":37.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.5,"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":"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":"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":318.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":15.67,"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":61.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":141.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.42,"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":27.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":91.04,"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":145.85,"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":19.12,"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":"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":"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":"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":5.9,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":3.62,"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":"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":"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":"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":85.24,"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":23.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":782.83,"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":178.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":650.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":294.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":81.07,"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":31.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":50.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.58,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":23.46,"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":"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":"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":"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":"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":"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":"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":10.03,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":65.04,"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":56.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":175.8,"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":1104.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":37.21,"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":47.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":46.49,"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":113.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":329.11,"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":"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":"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":"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":"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":"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":"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":29.45,"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":43.02,"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":"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":"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":149.48,"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":238.23,"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":[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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":138.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.5,"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":"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":"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":"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":"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":"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":"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":213.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":911.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":192.84,"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":76.93,"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":"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":"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":"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":"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":"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":147.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":293.06,"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":"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":"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":"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":"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":"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":73.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":28.21,"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":"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":"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":"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":"negotiated","negotiated_rate":14.04,"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":"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":"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":27.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":973.41,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":70.71,"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":130.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":121.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":2168.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":134.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":22.18,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":65.48,"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":104.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":219.48,"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":"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":"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":"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":"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":"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":"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":"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":9.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":742.3,"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":"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":"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":"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":"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":"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":"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":247.56,"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":317.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":315.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":12.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":130.46,"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":71.36,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93288","name":"Interrog evl pm/ldls pm ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead pacemaker system, or leadless pacemaker system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":72.97,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":82.53,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":241.14,"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":155.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":47.2,"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":37.21,"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":"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":"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":"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":"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":"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":"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":121.21,"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":49.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.5,"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":"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":"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":"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":"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":116.04,"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":161.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":239.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":118.76,"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":"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":"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":"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":"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":"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":"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":"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":33.81,"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":59.57,"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":[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":"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":"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":"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":"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":"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":"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":"99308","name":"Sbsq nf care low mdm 20","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.74,"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":67.56,"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":"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":"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":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":22.74,"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":"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":"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":"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":"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":"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":59.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":102.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":255.17,"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":"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":"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":"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":"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":24.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1359.14,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":69.06,"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":"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":"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":"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":2294.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":126.17,"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":76.52,"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":"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":78.35,"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":35.72,"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":935.4,"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":"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":"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":"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":"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":655.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":101.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":143.06,"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":[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":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":"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":"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":"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":"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":26.33,"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":"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":"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":"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":"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":52.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":59.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1542.14,"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":"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":"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":"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":"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":"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":53.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":52.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":88.57,"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":60.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1174.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":75.1,"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":916.61,"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":"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":"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":"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":"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":"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":"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":99.72,"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":37.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":144.74,"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":258.02,"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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":63.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":73.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":118.5,"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":"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":"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":"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":"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":1262.54,"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":"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":"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":"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":99.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":100.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":75.8,"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":"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":"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":920.11,"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":621.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":30.62,"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":"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":"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":79.88,"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":59.45,"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":"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":116.84,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":113.88,"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":226.1,"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":254.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":91.9,"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":"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":"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":"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":"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":"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":"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":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":122.41,"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":[3]}]},{"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":"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":230.03,"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":"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":"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":"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":"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":"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":"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":"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":"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":22.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":146.66,"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":74.88,"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":"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":"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":"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":"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":71.75,"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":83.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":317.87,"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":392.33,"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":"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":"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":"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":"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":82.19,"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":139.33,"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":[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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":74.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":56.79,"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":66.56,"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":"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":"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":"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":"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":"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":73.28,"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":133.75,"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":"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":"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":"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":"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":"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":7.76,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.71,"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":36.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.41,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.53,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":82.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":210.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":308.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":44.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":79.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":16.61,"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":"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":"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":"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":"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":67.01,"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":100.73,"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":"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":"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":"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":"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":1851.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":741.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":44.96,"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":108.05,"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":"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":"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":"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":"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":"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":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":110.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":2.36,"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":"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":"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":57.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":104.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":68.01,"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":59.27,"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":[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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":68.02,"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":38.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":75.5,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":159.17,"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":249.42,"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":[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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":178.82,"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":782.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":155.39,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":241.17,"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":132.55,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":25.87,"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":"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":"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":"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":"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":53.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":245.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":90.67,"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":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"]}],"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":349.48,"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":280.91,"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":"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":"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":"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":"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":"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":1178.46,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":21.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":38.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":14.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":173.18,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.36,"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":"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":"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":"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":"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":"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":"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":781.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":80.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":50.03,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":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":117.62,"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":[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":"10047","negotiated_rates":[{"negotiated_prices":[{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.08,"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":"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":"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":"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":"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":"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":"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":62.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":319.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":218.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1295.21,"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":"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":"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":"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":"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":1.24,"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":4.58,"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":"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":"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":"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":"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":"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":48.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":39.83,"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":"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":"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":365.3,"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":"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":"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":"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":"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":19.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":54.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.56,"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":"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":"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":"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":83.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":729.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":233.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":86.52,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":147.1,"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":237.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":20.87,"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":"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":"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":"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":"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":"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":"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":54.44,"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":42.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":105.77,"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":186.3,"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":"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":25.68,"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":"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":"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":39.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":48.97,"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":26.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":54.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":63.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":371.58,"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":"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":"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":"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":"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":26.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":48.38,"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":[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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":62.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":133.12,"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":"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":"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":"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":"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":"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":"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":17.51,"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":24.2,"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":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":38.48,"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":"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":"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":"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":"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":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":"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":"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":"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":["AU","AV"]}],"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":"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":"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":"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":"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":7.53,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":65.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.33,"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":"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":"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":"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":"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":"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":"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":42.16,"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":24.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":63.01,"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":"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":"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":"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":"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":"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":"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":"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":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-06","zip":"10501","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":[6]}]},{"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":"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":"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":88.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":53.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":202.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":47.72,"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":34.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":216.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":1542.14,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":21.88,"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":28.99,"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":[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":"1320201","zip":"10001","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"]}],"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","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":130.68,"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":501.81,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":132.27,"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":269.09,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":104.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":62.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":21.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":27.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":244.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":24.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":193.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1097.72,"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":107.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":646.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":959.9,"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":"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":8.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":16.86,"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":"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":"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":"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":87.71,"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":188.15,"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":101.39,"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":[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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":100.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.35,"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":"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":"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":"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":"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":"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":1113.71,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":122.8,"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":68.03,"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":[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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":50.84,"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":"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":"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":"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":"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":85.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.13,"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":"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":"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":"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":25.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.1,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.34,"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":26.6,"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":"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":"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":"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":791.85,"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":177.44,"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":"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":108.63,"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":71.08,"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":"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":"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":"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":"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":147.56,"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":44.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":51.36,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":189.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":81.01,"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":133.7,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.84,"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":"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":"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":"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":"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":4.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":715.13,"expiration_date":"9999-12-31","billing_class":"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":"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":338.79,"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":501.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":65.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":44.96,"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":108.05,"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":"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":"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":"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":"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":"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":27.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":19.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":25.1,"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":"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":160.83,"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":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67405","name":"Explore/drain eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":163.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":461.45,"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":"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":"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":"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":"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":"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":61.73,"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":125.99,"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":"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":"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":"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":104.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.55,"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":"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":"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":"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":"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":576.07,"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":"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":"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":"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":"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":335.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":63.89,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":18.42,"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":27.05,"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":"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":"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":"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":"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":"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":"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":11.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":56.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2165.37,"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":"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":"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":"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":"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":"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":22.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.28,"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":"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":"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":"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":44.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":72.23,"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":127.33,"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":"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":"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":"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":93.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":119.48,"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":291.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":77.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":8.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.48,"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":62.44,"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":"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":"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":3.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":92.05,"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":41.84,"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":[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":"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":"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":"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":"negotiated","negotiated_rate":1093.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":82.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":"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":130.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1661.19,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2391.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":71.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"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"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15120","name":"Splt agrft f/s/n/h/f/g/m 1st","description":"Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)","date_of_service":"2026-06-06","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":"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":"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":"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":"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":"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":"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":"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":69.45,"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":"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":"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":14.08,"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":"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":"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":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"]},{"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"]}],"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":55.96,"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":"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":"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":"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":24.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":66.82,"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":53.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":197.87,"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":116.45,"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":"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":31.34,"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":24.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":365.09,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":32.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":160.76,"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":"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":"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":"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":"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":69.14,"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":48.38,"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":[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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":345.56,"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":"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":958.57,"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":"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":1247.88,"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":664.27,"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1446.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":741.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":42.01,"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":54.44,"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":[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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":78.71,"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":"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":920.12,"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":"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":"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":27.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":49.01,"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":[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","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":158.03,"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":454.72,"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":"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":"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":"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":37.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":131.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":57.3,"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":49.44,"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":"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":"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":"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":"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":"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":"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":48.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":99.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":172.32,"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":"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":"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":96.06,"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":127.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":106.55,"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":48.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":437.64,"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":"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":"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":"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":1151.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":178.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":43.83,"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":53.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":234.11,"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":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"]}],"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":35.93,"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":18.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","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":"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":"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":"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":27.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":270.29,"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":"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":"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":"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":203.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":570.8,"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":"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":"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":"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":"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":"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":"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":206.72,"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":118.52,"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":[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","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"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":"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":96.83,"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":72.79,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":965.05,"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":664.52,"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":129.71,"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":65.53,"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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":9.07,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":681.29,"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":508.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1268.36,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":13.01,"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":"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":"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":"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":362.27,"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":525.5,"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":330.19,"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":"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":734.12,"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":"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":"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":"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":"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":34.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":100.97,"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":56.99,"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":"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":"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":"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":"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":"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":715.13,"expiration_date":"9999-12-31","billing_class":"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":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":83.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":19.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":54.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":246.92,"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":"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":"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":"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":"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":"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":"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":"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":34.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":113.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.07,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":378.38,"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":307.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":178.73,"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":140.33,"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":"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":"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":"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":"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":"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":"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":"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":10.72,"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":"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":"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":"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":"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":"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":"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":"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":85.71,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":134.74,"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":81.14,"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":[4]}]},{"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":"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":"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":"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":"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":29.41,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":30.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":53.24,"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":"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":18.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":24.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":44.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":398.81,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":18.93,"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":"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":"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":"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":"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":"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":"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":"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":51.96,"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":27.68,"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":[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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":950.56,"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":67.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":938.92,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.83,"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":"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":"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":"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":"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":2.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.53,"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":"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":"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":"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":"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":"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":36.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":68.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":128.11,"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":82.85,"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":"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":"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":"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":"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":"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":8.83,"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":"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":"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":"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":153.53,"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":275.82,"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":"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":"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":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":48.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":106.67,"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":154.68,"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":"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":"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":"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":"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":"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":"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":"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":83.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":113.58,"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":"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":"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":"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":218.06,"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":"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":"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":"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":844.82,"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":27.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":49.01,"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":[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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":44.71,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":56.36,"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":45.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":17.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":114.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":"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":231.3,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":109.73,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":61.58,"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":118.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":193.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":329.86,"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":258.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.16,"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":"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":"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":243.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":121.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":66.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":48.42,"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":32.78,"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":[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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":94.98,"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":1148.19,"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":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":"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":"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":"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":"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":"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":"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":42.03,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.51,"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":"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":"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":"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":68.33,"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":"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":"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":145.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":332.87,"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":"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":"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":"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":"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":96.8,"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":82.58,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":357.8,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":244.7,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":21.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":131.01,"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":"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":"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":"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":15.61,"expiration_date":"9999-12-31","billing_class":"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.69,"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":"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":"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":"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":"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":"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":"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":"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":2180.73,"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":"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":"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":6.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":104.99,"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":65.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":80.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":107.84,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1170.53,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2017.26,"expiration_date":"9999-12-31","billing_class":"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","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":280.51,"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":"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":7.46,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":1797.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.37,"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":34.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":244.13,"expiration_date":"9999-12-31","billing_class":"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":22.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":33.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":51.5,"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":"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":"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":27.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":64.03,"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":"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":"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":"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":"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":35.72,"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":"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":"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":60.62,"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":"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":"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":"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":"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":"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":"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":"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":536.66,"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":"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":"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":"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":3.2,"expiration_date":"9999-12-31","billing_class":"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","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":365.3,"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":"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":"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":"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":"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":"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":"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":10.13,"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":"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":"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":"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":6.06,"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":"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":16.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":327.39,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":23.11,"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":16.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":91.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1148.03,"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":"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":81.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":133.58,"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":"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":"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":"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":"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":"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":42.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":48.57,"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":31.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":50.48,"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":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"]}],"provider_references":[4]}]},{"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":51.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":65.1,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.63,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":94.97,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":23.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":37.1,"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":"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":"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":"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":"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":"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":"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":16.6,"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":8.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"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":"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":29.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":44.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":147.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":904.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":48.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":61.13,"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":24.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":35.21,"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":"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":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"]},{"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"]}],"provider_references":[3]}]},{"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":"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":"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":"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":27.95,"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":"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":"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":"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":"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":"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":"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":665.25,"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":1238.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":50.21,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":96.06,"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":"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":"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":"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":"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":"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":65.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2017.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":3005.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":114.37,"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":51.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":32.03,"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":"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":"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":"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":"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":"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":26.3,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":32.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.12,"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":"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":"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":"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":"negotiated","negotiated_rate":8.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":249.42,"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":159.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2179.79,"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":191.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":18.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":35.93,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12031","name":"Intmd rpr s/a/t/ext 2.5 cm/<","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":186.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":55.29,"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":42.78,"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"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":53.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.4,"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":"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":"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":"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":25.74,"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":46.31,"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":[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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":347.58,"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":"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":"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":"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":"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":"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":116.24,"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":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"]}],"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":"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":"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":114.03,"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":"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":"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":"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":1797.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":13.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":114.38,"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":3039.57,"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":[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":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":"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":"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":"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":"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":"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":"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":"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":"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":17.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":24.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":35.57,"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":31.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":102.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":118.58,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":793.68,"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":"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":"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":"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":"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":"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":"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":"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":"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":76.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":231.3,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":13.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":64.22,"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":"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":"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":79.23,"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":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"]}],"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":"1328299","zip":"12007","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":141.62,"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":61.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":115.13,"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":51.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":99.16,"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":38.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":63.2,"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":48.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":175.94,"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":214.14,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.37,"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":"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":"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":"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":183.88,"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":"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":"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":23.68,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":66.28,"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":38.91,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":24.73,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":28.75,"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":41.92,"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":[3]}]},{"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":"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":"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":"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":"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":283.25,"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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":9.99,"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":"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":16.34,"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":27.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":152.63,"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":194.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":112.31,"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":131.24,"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":"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":"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":"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":1447.61,"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2249.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":50.63,"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":62.69,"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":211.85,"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":124.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":258.02,"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":144.74,"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":"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":71.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":86.08,"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":110.53,"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":"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":"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":1901.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":36.16,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":97.64,"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":"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":"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":"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":"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":96.41,"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":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"]}],"provider_references":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":24.78,"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":19.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":16.12,"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":6.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.44,"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":"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":"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":"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":"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":"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":"29550","name":"Strapping of toes","description":"Strapping; toes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.22,"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":16.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1424.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":228.12,"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":293.68,"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":"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":"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":"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":102.3,"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":143.35,"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":"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":"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":"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":"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":"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":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":22.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":96.59,"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":199.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.83,"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":"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":13.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.1,"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":"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":"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":"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":125.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.32,"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":"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":"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":"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":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":7.1,"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":"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":"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":"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":"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":50.99,"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":20.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":124.8,"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":"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":"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":"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":65.57,"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":111.92,"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":[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","locality":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":383.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":80.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":103.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.93,"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":"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":"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":"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":"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":6.67,"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":"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":"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":"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":"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":"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":26.42,"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":45.87,"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":"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":"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":"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":170.18,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.91,"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":"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":"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":"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":"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":"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":"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":"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":1084.22,"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":"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":"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":1122.99,"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":"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":"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":"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":"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":"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":"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":"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":23.36,"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":17.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":50.99,"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":20.2,"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":"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":"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":"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":"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":"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":"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":18.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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":16.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":"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":"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":118.61,"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":100.28,"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":[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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-06-06","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":27.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":289.41,"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":"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":"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":"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":"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":"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":"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":97.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":31.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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":45.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1239.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":40.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":57.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":108.38,"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":"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":"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":"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":"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":"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":"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":69.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.61,"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":"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":"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":"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":85.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":220.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":95.98,"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":186.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":190.22,"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":"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":"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":"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":79.67,"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":44.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":623.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":67.89,"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":141.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":80.87,"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":"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":19.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":40.58,"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":"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":"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":"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":"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":"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":"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":"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":130.42,"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":154.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":319.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.62,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":126.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":98.5,"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":84.2,"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":"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":"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":"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":"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":150.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":644.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":94.41,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":469.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":368.79,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.27,"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":"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":"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":275.12,"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":405.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":14.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":80.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":37.47,"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":20.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":75.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.63,"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":"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":"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":"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":"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":213.12,"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":131.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1524.71,"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":"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":"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":"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":"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":"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":"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":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":"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":"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":24.35,"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":"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":"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":"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":"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":"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":"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":"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":98.13,"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":116.18,"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":[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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":75.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":28.64,"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":21.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":874.19,"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":"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":"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":"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":60.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":191.62,"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":2179.79,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":680.84,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":8.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-06","zip":"14001","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":[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":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":"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":73.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":13.28,"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":11.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":9.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":8.66,"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":"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":"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":91.62,"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":"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":"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":1122.99,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":52.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":319.31,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":83.9,"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":"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":"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":"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":"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":"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":"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":12.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":38.9,"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":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1163.3,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":3.8,"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":"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":"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":"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":"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":31.91,"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":48.92,"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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":182.34,"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":2620.13,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":392.33,"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":317.87,"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":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":"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":"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":"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":"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":"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":"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":"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":16.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":23.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":85.24,"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":"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":"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":26.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":39.94,"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":21.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.83,"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":170.99,"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":16.6,"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":8.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"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":"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":"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":99.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":174.25,"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":"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":163.53,"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.48,"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":"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":"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":"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":"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":"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":"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":51.11,"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":115.13,"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":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.9,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3724.05,"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":304.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":48.18,"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":27.75,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"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":"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":"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":"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":"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":24.54,"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":18.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":329.11,"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":255.17,"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":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":[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","zip":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":155.39,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":291.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":315.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"H2019","name":"Ther behav svc, per 15 min","description":"Therapeutic behavioral services, per 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1142.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["U4"]}],"provider_references":[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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":94.91,"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":40.16,"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":"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":"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":"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":"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":"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":4.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":23.38,"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":"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":"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":"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":"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":80.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":122.11,"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":212.36,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":247.56,"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":317.13,"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":"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":"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":"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":"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":"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":141.22,"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":544.21,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":87.71,"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":"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":"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":"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":"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":90.28,"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":61.1,"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":[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":"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":"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":"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":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":"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":"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":"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":"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":36.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":87.68,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":28.94,"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":21.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","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":"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":"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":"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":"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":"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":"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":"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":169.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":13.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":52.72,"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":"1320201","zip":"10001","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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.8,"expiration_date":"9999-12-31","billing_class":"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":140.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":258.43,"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":"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":"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":2.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":23.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":82.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":920.0,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1.55,"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":"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":"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":"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":"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":"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":67.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":126.8,"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":[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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.3,"expiration_date":"9999-12-31","billing_class":"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":271.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":117.26,"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":41.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.1,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":243.96,"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":314.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":203.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":97.45,"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":"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":"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":"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":"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":"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":"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":45.34,"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":31.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1160.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":79.56,"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":"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":"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":102.07,"expiration_date":"9999-12-31","billing_class":"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":137.09,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":4.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":78.05,"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":36.14,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":138.74,"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":223.78,"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":[3]}]},{"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":"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":"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":32.18,"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":"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":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":17.28,"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":"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":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"]},{"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"]}],"provider_references":[4]}]},{"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":"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":"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":"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":6.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":26.32,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":124.89,"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":2219.69,"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":"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":"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":"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":"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":33.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":9.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":13.7,"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":[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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":62.25,"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":90.55,"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":[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":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":"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":"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":"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":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":"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":"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":"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":47.91,"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":27.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":370.93,"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":293.35,"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":"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":"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":"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":"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":"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":71.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":62.16,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":23.09,"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":16.78,"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":[3]}]},{"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":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"]},{"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":56.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":229.47,"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":68.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":116.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":178.22,"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":215.76,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":38.27,"expiration_date":"9999-12-31","billing_class":"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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.64,"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":"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":"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":"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":1088.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":218.95,"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":"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":"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":"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":"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":"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":6.86,"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":"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":"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":"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":"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":"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":15.61,"expiration_date":"9999-12-31","billing_class":"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":49.74,"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":73.28,"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":"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":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"]},{"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"]}],"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":"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":928.28,"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":634.58,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":44.45,"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":"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":"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":"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":"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":"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":"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":"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":146.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":1.69,"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":"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":"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":"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":163.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":461.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":46.31,"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":25.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":52.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.87,"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":"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":"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":"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":"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":"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":162.21,"expiration_date":"9999-12-31","billing_class":"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","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":41.92,"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":28.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":23.68,"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":109.11,"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":"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":"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":406.61,"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":129.47,"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":"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":"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":"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":"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":"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":111.89,"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":34.75,"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":"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":"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":"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":"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":"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":"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":5.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":13.49,"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":"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":"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":"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":"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":"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":277.97,"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":"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":"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":"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":36.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":83.31,"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":"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":"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":"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":"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":49.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":72.07,"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":"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":"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":"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":"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":81.45,"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":104.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":90.81,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":33.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":13.01,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":41.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":1083.13,"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":"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":"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":"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":"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":"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":"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":"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":595.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":109.19,"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":151.16,"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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":490.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":8.49,"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":"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":"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":"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":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"]},{"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"]}],"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":25.01,"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":19.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":41.51,"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":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":[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","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":73.02,"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":"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":34.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.02,"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":16.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":39.62,"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":"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":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":33.28,"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":"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":79.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.3,"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":"93792","name":"Pt/caregiver traing home inr","description":"Patient/caregiver training for initiation of home international normalized ratio (inr) monitoring under the direction of a physician or other qualified health care professional, face-to-face, including use and care of the inr monitor, obtaining blood sample, instructions for reporting home inr test ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.14,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1318.62,"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":"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":2.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.25,"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":"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":"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":"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":"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":"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":39.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.94,"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":"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":564.62,"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":1033.68,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":51.82,"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":"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":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":859.39,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":52.72,"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":"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":"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":"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":"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":"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":"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":"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":35.7,"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":93.03,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":122.19,"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":46.69,"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":"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":27.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":50.21,"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":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":"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":"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":"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":"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":"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":"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":"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":118.31,"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":"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":"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":"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":"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":"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":"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":"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":52.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":75.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.91,"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":66.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":41.03,"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":23.18,"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":"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":"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":"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":5.83,"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":"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":"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":"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":"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":"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":32.36,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":48.42,"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":"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":"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":79.88,"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":59.45,"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":"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":"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":7.76,"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":"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":"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":"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":"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":"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":"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":24.85,"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":46.03,"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":189.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":202.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":37.2,"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":469.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.05,"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":"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":"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":"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":"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":37.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":89.7,"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":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":1.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":37.61,"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":"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":"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":"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":"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":"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":"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":958.57,"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":"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":27.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":73.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":34.31,"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":21.2,"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":[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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":64.42,"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":30.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":10.25,"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":"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":"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":19.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":138.21,"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":253.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":230.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1268.36,"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":681.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.37,"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":"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":"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":"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":"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":24.96,"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":"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":114.2,"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":"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":"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":"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":"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":"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":"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":"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":108.71,"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":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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":61.1,"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":90.28,"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":39.92,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":21.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":100.08,"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":118.73,"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":[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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":274.07,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":52.72,"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":130.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.24,"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":"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":"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":"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":"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":"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":"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":"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":139.33,"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":82.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1029.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":104.81,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1002.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":44.12,"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":"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":70.1,"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":119.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":111.48,"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":194.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":147.86,"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":"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":"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":18.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":34.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":45.44,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.65,"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":102.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.07,"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":"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":"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":"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":"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":"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":"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":143.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":253.71,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-06","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":388.14,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.9,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":93.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"10910","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":"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":"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":"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":"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":101.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":143.06,"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":103.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":2641.1,"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":"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":"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":"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":"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":"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":"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":"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":"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":15.97,"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":6.65,"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":"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":"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":232.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":113.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":212.36,"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":122.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":25.41,"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":64.43,"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1083.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":2.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":30.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2155.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":346.26,"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":274.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":53.93,"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":"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":48.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":564.62,"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":1033.68,"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":55.36,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":32.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":147.51,"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":"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":"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":"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":"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":"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":"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":"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":11.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":244.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":585.51,"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":"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":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","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":"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":"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":"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":"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":"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":7.1,"expiration_date":"9999-12-31","billing_class":"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","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.06,"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":"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":"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":"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":"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":"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":6.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":55.29,"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":42.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1166.05,"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":115.22,"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":[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":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":51.17,"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":[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","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":293.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":318.41,"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":468.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.67,"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":"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":18.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":62.92,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":2.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":35.69,"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":114.62,"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":"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":"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":"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":110.53,"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":86.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":2673.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":190.76,"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":103.49,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":35.63,"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":118.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":69.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":75.61,"expiration_date":"9999-12-31","billing_class":"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.5,"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":"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":6.47,"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":"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":"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":"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":"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":"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":"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":"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":"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":334.32,"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":62.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":129.1,"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":[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":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":300.68,"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":374.7,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":244.7,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":82.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-06","zip":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":230.18,"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":"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":27.47,"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":"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":"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":"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":"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":26.76,"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":"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":86.52,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.5,"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":"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":"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":"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":"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":"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":"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":"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":85.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":84.2,"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":98.5,"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":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":"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":"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":"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":"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":"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":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"]},{"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"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":85.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":1194.79,"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":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":[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":"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":"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":"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":7.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":170.18,"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":"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":"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":2058.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":2323.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":156.22,"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":"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":"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":"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":928.28,"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":634.58,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":37.47,"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":"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":"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":"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":"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":"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":"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":6.11,"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":"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":"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":"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":26.86,"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":21.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":22.06,"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":39.82,"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":"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":"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":"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":"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":27.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":52.72,"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":"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":"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":"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":"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":519.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":358.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":232.3,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":56.75,"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":66.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.22,"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":68.11,"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":[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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":22.52,"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":"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":"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":"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":"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":"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":"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":4.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":670.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":44.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":63.84,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":57.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":131.22,"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":59.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1802.66,"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":"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":"negotiated","negotiated_rate":929.04,"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":320.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":21.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":902.69,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.69,"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":"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":"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":"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":"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":269.12,"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":171.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":580.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":805.16,"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":"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":"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":"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":"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":"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":"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":"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":"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":130.41,"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":"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":"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":"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":"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":8.53,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.99,"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":49.2,"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":[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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":95.87,"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":113.15,"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":"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":"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":1874.73,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":732.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":91.04,"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":145.85,"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":"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":"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":"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":39.83,"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":"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":"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":"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":60.8,"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":398.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":153.83,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":32.64,"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":49.32,"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":[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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":46.19,"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":30.83,"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":[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":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":339.35,"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":150.81,"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":"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":"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":"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":"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":"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":"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":100.08,"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":118.73,"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":[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":"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":"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":28.31,"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":48.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":583.93,"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":860.7,"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":[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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":3.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":130.62,"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":"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":"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":"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":"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":"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":"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":2884.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63020","name":"Lamot dcmprn nrv rt 1 cerv","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical","date_of_service":"2026-06-06","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":61.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":88.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"CPT","billing_code_type_version":"2026","billing_code":"91315","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":107.54,"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":63.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":99.16,"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":38.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":56.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":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":11.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":175.8,"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":1104.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1635.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":79.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":23.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":29.45,"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":"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":"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":"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":"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":13.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":"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":"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":"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":66.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":530.51,"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":"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":"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":"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":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":27.35,"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":"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":"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":"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":274.89,"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":134.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":31.82,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":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"]}],"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":"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":7.21,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.55,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.5,"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":"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":"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":"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":"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":"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":"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":"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":851.4,"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":"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":"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":643.07,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":43.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":161.34,"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":116.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":117.05,"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":"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":"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":"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":"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":"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":"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":"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":2.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":141.42,"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":172.12,"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":488.26,"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":"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":"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":"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":1302.98,"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":"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":"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":52.72,"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":"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":"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":"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":861.52,"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":"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":"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":"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":"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":"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":"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":40.08,"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":135.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":82.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":143.08,"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":87.48,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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","locality":"1329204","zip":"11004","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":52.71,"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":65.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":8.53,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.23,"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":"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":"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":"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":22.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"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"]}],"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":99.26,"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":204.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.93,"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":"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":"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":"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":"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":"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":"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":"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":"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":129.47,"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":406.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":49.32,"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":32.64,"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":[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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["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","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":117.92,"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":306.91,"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":"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":"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":"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":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-06","zip":"10910","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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":252.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.3,"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":"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":51.82,"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":"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":"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":"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":"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":"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":"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":102.3,"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":143.35,"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":"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":"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":"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":"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":"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":57.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":98.15,"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":"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":"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":"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":"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":"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":"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":"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":"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":1558.94,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":253.48,"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":138.21,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":25.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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"]}],"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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":27.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[6]}]},{"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":"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":"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":"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":"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":"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":"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":"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":38.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":31.09,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":106.7,"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":185.88,"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":"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":"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":"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":"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":"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":"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":"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":275.12,"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":405.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":62.11,"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":38.52,"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":"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":"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":"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":87.87,"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":27.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.71,"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":26.13,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":118.55,"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","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[5]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":103.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":9.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":184.65,"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":2296.43,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":78.92,"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":"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":"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":"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":"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":901.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":883.04,"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":"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":"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":"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":"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":"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":298.01,"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":235.66,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":99.99,"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":35.08,"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":"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":70.43,"expiration_date":"9999-12-31","billing_class":"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","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":758.57,"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1029.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":97.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":12.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":70.71,"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":"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":"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":"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":"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":"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":"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":20.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":76.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-06","zip":"10910","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":"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":"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":13.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"negotiated_type":"negotiated","negotiated_rate":12.5,"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":"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":"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":"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":"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":90.61,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.68,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":64.3,"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":115.04,"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":[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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":151.16,"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":109.19,"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":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":34.07,"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":"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":"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":"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":171.55,"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":"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":"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":"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":"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":42.56,"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":17.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":5.9,"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":30.6,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":117.45,"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":137.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":13.57,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":35.72,"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":"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":"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":84.22,"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":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36580","name":"Replace cvad cath","description":"Replacement, complete, of a non-tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access","date_of_service":"2026-06-06","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3161.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":115.5,"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":47.4,"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":253.71,"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":143.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1099.57,"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":"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":"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":"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":"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":"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":"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":"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":151.46,"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":"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":97.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":504.44,"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":744.56,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":82.52,"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":"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":"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":"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":140.33,"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":178.73,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.3,"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":"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":"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":124.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":206.41,"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":72.43,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.47,"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":"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":"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":"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":"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":"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":"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":55.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.45,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"CPT","billing_code_type_version":"2026","billing_code":"20553","name":"Njx 1/mlt trigger points 3/>","description":"Injection(s); single or multiple trigger point(s), 3 or more muscles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.39,"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":52.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":68.88,"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":58.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","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":"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":"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":"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":"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":"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":"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":793.68,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1142.35,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":203.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":53.55,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":88.51,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":61.55,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":46.25,"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":57.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.07,"expiration_date":"9999-12-31","billing_class":"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":"1329204","zip":"11004","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26","TC"]}],"provider_references":[2]}]},{"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":"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":"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":"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":"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":"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":18.12,"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":"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":115.22,"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":1166.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":72.79,"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":96.83,"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":[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":"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":"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":"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":"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":"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":46.41,"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":56.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":10.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":15.64,"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":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96377","name":"Applicaton on-body injector","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":48.93,"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":96.6,"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":[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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":16.28,"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":6.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":41.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":191.26,"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":47.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":103.49,"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":267.47,"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1039.88,"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":164.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":76.81,"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":130.37,"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":"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":"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":"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":"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":"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":"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":"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":"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":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-06","zip":"10501","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":[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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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","zip":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.04,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":72.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":143.92,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":58.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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"]}],"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":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320203","zip":"10512","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":17.33,"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":"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":"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":"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":"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":"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":"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":1174.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.28,"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":"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":"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":"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":"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":58.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":143.6,"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":87.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":99.35,"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":38.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":732.74,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.22,"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":68.11,"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":[4]}]},{"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":"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":76.69,"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":54.08,"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":[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":"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":"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":6.39,"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":15.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":79.41,"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":134.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1238.99,"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":665.25,"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":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":83.9,"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":"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":"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":"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":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["TC"]},{"negotiated_type":"negotiated","negotiated_rate":18.77,"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":"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":"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":25.97,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":20.79,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":13.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":69.7,"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":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"]}],"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":"10047","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"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":"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":"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":"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":14.34,"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":10.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98927","name":"Osteopath manj 5-6 regions","description":"Osteopathic manipulative treatment (omt); 5-6 body regions involved","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.8,"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":52.27,"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":20.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":66.35,"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":56.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":28.64,"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":21.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"negotiated","negotiated_rate":76.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":64.5,"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":"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":"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":"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":"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":"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":62.11,"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":41.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":87.48,"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":143.08,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":114.02,"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":44.07,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":14.02,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":165.9,"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":"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":"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":"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":"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":284.3,"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":115.76,"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":"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":"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":82.12,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1060.5,"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":"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":51.85,"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":28.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":110.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":5.9,"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":"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":"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":"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":"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":"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":"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":"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":6.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":166.17,"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":263.59,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":664.52,"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":965.05,"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":"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":57.38,"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":84.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-06","zip":"10047","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.23,"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":"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":"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":"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":"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":"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":"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":"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":31.09,"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":"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":"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":"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":"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":26.68,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":79.94,"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":43.81,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":66.9,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":113.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"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":"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":"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":"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":"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":213.86,"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":312.14,"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":390.17,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":767.84,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.94,"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":"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":"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":"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":371.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":34.75,"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":111.89,"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":"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":"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":56.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]},{"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"]}],"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":800.42,"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":52.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"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":"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":23.87,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":26.68,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":18.34,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":179.47,"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":2278.81,"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":[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":"10501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":38.9,"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":24.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":17.8,"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":24.65,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":29.96,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":11.24,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":23.98,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":81.59,"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":169.79,"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":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":25.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":37.25,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":223.28,"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":"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":"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":"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":"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":"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":"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":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.78,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":96.62,"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":82.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.35,"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":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"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78453","name":"Ht muscle image planar sing","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":45.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":35.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":96.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":234.14,"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":[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":"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":"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":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":"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":"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":"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":"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":"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":125.19,"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":75.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":213.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":98.15,"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":57.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"10301","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":48.18,"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":27.75,"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":[4]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.55,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":107.54,"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":63.75,"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":"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":"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":1635.89,"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":"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":5.83,"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":"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":"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":"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":"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":"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":501.81,"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":130.68,"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":[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","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":274.89,"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":134.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":14.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":130.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":78.89,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":40.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":51.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":2986.26,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":148.55,"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":"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":"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":"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":"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":100.61,"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":85.85,"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":"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":"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":"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":"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":"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":"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":"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":339.35,"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":150.81,"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":77.51,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":261.2,"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":"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":"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":"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":"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":"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":"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":"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":83.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":113.58,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":737.77,"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":168.59,"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":"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":"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":59.68,"expiration_date":"9999-12-31","billing_class":"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","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":"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":"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":"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":"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":46.37,"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":"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":103.43,"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":1777.15,"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":"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":"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":33.77,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"negotiated_type":"negotiated","negotiated_rate":142.73,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":6.67,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":228.12,"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":293.68,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":80.21,"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":21.91,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":57.11,"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":40.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"provider_references":[1]}]},{"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":94.68,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":224.81,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":7.05,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":47.96,"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":19.43,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.83,"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":"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":"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":"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":"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":"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":60.91,"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":134.78,"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":36.2,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1.32,"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":5.16,"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":[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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":7.1,"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":"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":"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":"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":"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":"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":104.27,"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":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":[3]}]},{"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":"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":"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":"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":75.5,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":47.59,"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":114.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":24.78,"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":19.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":36.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":80.09,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":59.54,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":3.22,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":15.61,"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":"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":"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":52.72,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":226.2,"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":127.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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","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":"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":"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":"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":"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":"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":1170.89,"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":630.23,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":30.83,"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":46.19,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":31.82,"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":"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":"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":"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":"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":"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":"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":337.88,"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":"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":"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":298.33,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.4,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":1350.56,"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":"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":"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":"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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":266.92,"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":"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":"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":"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":"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":"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":"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":6.06,"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":"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":38.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":338.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":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"]},{"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":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":"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":"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":"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":"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":48.75,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":73.02,"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":"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":"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":"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":"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":130.01,"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":368.47,"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":"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":"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":59.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]},{"negotiated_type":"negotiated","negotiated_rate":26.27,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":66.11,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":27.38,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":4.13,"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":"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":20.42,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":61.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":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"]},{"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"]}],"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","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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"negotiated","negotiated_rate":113.28,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":81.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"negotiated_type":"negotiated","negotiated_rate":165.29,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":52.45,"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":29.95,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":16.12,"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":6.64,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":99.35,"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":38.67,"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":"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":"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":"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":"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":"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":4.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"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":"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":994.78,"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":"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":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]},{"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":[4]}]},{"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":"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":"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":"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":83.42,"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":30.35,"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":"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":"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":"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":"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":"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":"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":"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":7.88,"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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":"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]}]}]}