|
Other Ophthalmic System Diagnoses
|
Facility
|
OP
|
$0.32
|
|
|
Service Code
|
EAPG 00553
|
| Min. Negotiated Rate |
$0.32 |
| Max. Negotiated Rate |
$0.32 |
| Rate for Payer: Sunshine Health Medicaid |
$0.32
|
|
|
Other Pathological Fractures W/O Musculoskeletal Malignancy
|
Facility
|
OP
|
$0.55
|
|
|
Service Code
|
EAPG 00649
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$0.55 |
| Rate for Payer: Sunshine Health Medicaid |
$0.55
|
|
|
Other Respiratory System Diagnoses
|
Facility
|
OP
|
$0.40
|
|
|
Service Code
|
EAPG 00576
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$0.40 |
| Rate for Payer: Sunshine Health Medicaid |
$0.40
|
|
|
Other Skin, Subcutaneous Tissue And Breast Diagnoses
|
Facility
|
OP
|
$0.23
|
|
|
Service Code
|
EAPG 00675
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$0.23 |
| Rate for Payer: Sunshine Health Medicaid |
$0.23
|
|
|
Other Transplant Procedures
|
Facility
|
OP
|
$11.65
|
|
|
Service Code
|
EAPG 03050
|
| Min. Negotiated Rate |
$11.65 |
| Max. Negotiated Rate |
$11.65 |
| Rate for Payer: Sunshine Health Medicaid |
$11.65
|
|
|
Otorhinolaryngologic Function Tests
|
Facility
|
OP
|
$0.28
|
|
|
Service Code
|
EAPG 00251
|
| Min. Negotiated Rate |
$0.28 |
| Max. Negotiated Rate |
$0.28 |
| Rate for Payer: Sunshine Health Medicaid |
$0.28
|
|
|
Pacemaker And Other Cardiovascular Device Insertion And Replacement
|
Facility
|
OP
|
$16.07
|
|
|
Service Code
|
EAPG 00086
|
| Min. Negotiated Rate |
$16.07 |
| Max. Negotiated Rate |
$16.07 |
| Rate for Payer: Sunshine Health Medicaid |
$16.07
|
|
|
Pain Related Diagnoses
|
Facility
|
OP
|
$0.29
|
|
|
Service Code
|
EAPG 00663
|
| Min. Negotiated Rate |
$0.29 |
| Max. Negotiated Rate |
$0.29 |
| Rate for Payer: Sunshine Health Medicaid |
$0.29
|
|
|
Pancreas Diagnoses Except Malignancy
|
Facility
|
OP
|
$0.44
|
|
|
Service Code
|
EAPG 00635
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.44 |
| Rate for Payer: Sunshine Health Medicaid |
$0.44
|
|
|
Pap Smears
|
Facility
|
OP
|
$0.03
|
|
|
Service Code
|
EAPG 00392
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.03 |
| Rate for Payer: Sunshine Health Medicaid |
$0.03
|
|
|
Partial Thickness Burns
|
Facility
|
OP
|
$0.39
|
|
|
Service Code
|
EAPG 00861
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$0.39 |
| Rate for Payer: Sunshine Health Medicaid |
$0.39
|
|
|
Pathology Consultation And Interpretation
|
Facility
|
OP
|
$0.19
|
|
|
Service Code
|
EAPG 00158
|
| Min. Negotiated Rate |
$0.19 |
| Max. Negotiated Rate |
$0.19 |
| Rate for Payer: Sunshine Health Medicaid |
$0.19
|
|
|
Patient Education, Group
|
Facility
|
OP
|
$0.09
|
|
|
Service Code
|
EAPG 00429
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$0.09 |
| Rate for Payer: Sunshine Health Medicaid |
$0.09
|
|
|
Patient Education, Individual
|
Facility
|
OP
|
$0.14
|
|
|
Service Code
|
EAPG 00428
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: Sunshine Health Medicaid |
$0.14
|
|
|
PC Incision and drainage pilonidal cyst (complicated)
|
Professional
|
Both
|
$1,058.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
810081
|
| Min. Negotiated Rate |
$136.70 |
| Max. Negotiated Rate |
$652.99 |
| Rate for Payer: Aetna Better Health CHIP/Medicaid |
$272.38
|
| Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility |
$170.88
|
| Rate for Payer: Behavioral Services Network Commercial |
$187.97
|
| Rate for Payer: Behavioral Services Network Medicare |
$170.88
|
| Rate for Payer: Carelon Medicare |
$170.88
|
| Rate for Payer: Lucet Commercial |
$153.79
|
| Rate for Payer: Lucet Commercial |
$136.70
|
| Rate for Payer: Lucet Commercial |
$162.34
|
| Rate for Payer: Magellan Medicaid |
$259.41
|
| Rate for Payer: Molina Complete Care Medicaid/Medicare |
$170.88
|
| Rate for Payer: Prime Health Services Workers Comp |
$652.99
|
|
|
PC Transitional Care face to face w/in 7 days d/c
|
Professional
|
Both
|
$830.00
|
|
|
Service Code
|
CPT 99496
|
| Hospital Charge Code |
4999496
|
| Min. Negotiated Rate |
$146.34 |
| Max. Negotiated Rate |
$427.70 |
| Rate for Payer: Aetna Better Health Medicare-Medicaid Dual Eligibility |
$182.93
|
| Rate for Payer: Behavioral Services Network Commercial |
$201.22
|
| Rate for Payer: Behavioral Services Network Medicare |
$182.93
|
| Rate for Payer: Carelon Medicare |
$182.93
|
| Rate for Payer: Lucet Commercial |
$164.64
|
| Rate for Payer: Lucet Commercial |
$173.78
|
| Rate for Payer: Lucet Commercial |
$146.34
|
| Rate for Payer: Molina Complete Care Medicaid/Medicare |
$182.93
|
| Rate for Payer: Prime Health Services Workers Comp |
$427.70
|
|
|
Peptic Ulcer And Gastritis
|
Facility
|
OP
|
$0.63
|
|
|
Service Code
|
EAPG 00621
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$0.63 |
| Rate for Payer: Sunshine Health Medicaid |
$0.63
|
|
|
Percutaneous Intra-Abdominal Or Intrathoracic Vascular Procedures
|
Facility
|
OP
|
$29.30
|
|
|
Service Code
|
EAPG 00122
|
| Min. Negotiated Rate |
$29.30 |
| Max. Negotiated Rate |
$29.30 |
| Rate for Payer: Sunshine Health Medicaid |
$29.30
|
|
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
Facility
|
OP
|
$28.07
|
|
|
Service Code
|
EAPG 00265
|
| Min. Negotiated Rate |
$28.07 |
| Max. Negotiated Rate |
$28.07 |
| Rate for Payer: Sunshine Health Medicaid |
$28.07
|
|
|
Peripheral And Other Vascular Diagnoses
|
Facility
|
OP
|
$0.30
|
|
|
Service Code
|
EAPG 00596
|
| Min. Negotiated Rate |
$0.30 |
| Max. Negotiated Rate |
$0.30 |
| Rate for Payer: Sunshine Health Medicaid |
$0.30
|
|
|
Peripheral And Other Vascular Related Injuries
|
Facility
|
OP
|
$0.44
|
|
|
Service Code
|
EAPG 00548
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.44 |
| Rate for Payer: Sunshine Health Medicaid |
$0.44
|
|
|
Peripheral, Cranial And Autonomic Nerve Diagnoses
|
Facility
|
OP
|
$0.28
|
|
|
Service Code
|
EAPG 00527
|
| Min. Negotiated Rate |
$0.28 |
| Max. Negotiated Rate |
$0.28 |
| Rate for Payer: Sunshine Health Medicaid |
$0.28
|
|
|
Peripheral, Cranial, And Autonomic Nerve Injuries
|
Facility
|
OP
|
$0.35
|
|
|
Service Code
|
EAPG 00545
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$0.35 |
| Rate for Payer: Sunshine Health Medicaid |
$0.35
|
|
|
Peripheral Vascular Bypass Procedures
|
Facility
|
OP
|
$10.99
|
|
|
Service Code
|
EAPG 00123
|
| Min. Negotiated Rate |
$10.99 |
| Max. Negotiated Rate |
$10.99 |
| Rate for Payer: Sunshine Health Medicaid |
$10.99
|
|
|
Personality And Impulse Control Diagnoses
|
Facility
|
OP
|
$0.51
|
|
|
Service Code
|
EAPG 00822
|
| Min. Negotiated Rate |
$0.51 |
| Max. Negotiated Rate |
$0.51 |
| Rate for Payer: Sunshine Health Medicaid |
$0.51
|
|
