|
PR PERC VERTEB AUGMENT/ KYPHOPLAST, EA ADD
|
Professional
|
Both
|
$505.00
|
|
|
Service Code
|
HCPCS 22525
|
| Min. Negotiated Rate |
$202.00 |
| Max. Negotiated Rate |
$328.25 |
| Rate for Payer: Aetna Medicare |
$252.50
|
| Rate for Payer: BCBS Complete |
$202.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$328.25
|
|
|
PR PERC VERTEB AUGMENT/ KYPHOPLAST, LUMBAR
|
Professional
|
Both
|
$1,075.00
|
|
|
Service Code
|
HCPCS 22524
|
| Min. Negotiated Rate |
$430.00 |
| Max. Negotiated Rate |
$698.75 |
| Rate for Payer: Aetna Medicare |
$537.50
|
| Rate for Payer: BCBS Complete |
$430.00
|
| Rate for Payer: Cash Price |
$860.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$698.75
|
|
|
PR PERC VERTEB AUGMENT/ KYPHOPLAST, THOR
|
Professional
|
Both
|
$1,141.00
|
|
|
Service Code
|
HCPCS 22523
|
| Min. Negotiated Rate |
$456.40 |
| Max. Negotiated Rate |
$741.65 |
| Rate for Payer: Aetna Medicare |
$570.50
|
| Rate for Payer: BCBS Complete |
$456.40
|
| Rate for Payer: Cash Price |
$912.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$741.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$741.65
|
|
|
PR PEREYRA PX W/ANTERIOR COLPORRHAPHY
|
Professional
|
Both
|
$2,213.00
|
|
|
Service Code
|
HCPCS 57289
|
| Min. Negotiated Rate |
$758.08 |
| Max. Negotiated Rate |
$1,438.45 |
| Rate for Payer: Aetna Commercial |
$1,015.83
|
| Rate for Payer: Aetna Medicare |
$788.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,091.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,015.83
|
| Rate for Payer: BCBS Complete |
$885.20
|
| Rate for Payer: BCBS MAPPO |
$758.08
|
| Rate for Payer: BCN Medicare Advantage |
$758.08
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cofinity Commercial |
$1,015.83
|
| Rate for Payer: Cofinity Commercial |
$1,091.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$758.08
|
| Rate for Payer: Healthscope Commercial |
$1,402.45
|
| Rate for Payer: Healthscope Commercial |
$1,212.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$795.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,438.45
|
| Rate for Payer: Nomi Health Commercial |
$909.70
|
| Rate for Payer: PACE SWMI |
$758.08
|
| Rate for Payer: PHP Medicare Advantage |
$758.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,438.45
|
| Rate for Payer: Priority Health Medicare |
$758.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$758.08
|
| Rate for Payer: UHC Medicare Advantage |
$758.08
|
|
|
PR PERICARDIOCENTESIS INITIAL
|
Professional
|
Both
|
$451.00
|
|
|
Service Code
|
HCPCS 33010
|
| Min. Negotiated Rate |
$180.40 |
| Max. Negotiated Rate |
$293.15 |
| Rate for Payer: Aetna Medicare |
$225.50
|
| Rate for Payer: BCBS Complete |
$180.40
|
| Rate for Payer: Cash Price |
$360.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.15
|
|
|
PR PERICARDIOCENTESIS SUBSEQUENT
|
Professional
|
Both
|
$450.00
|
|
|
Service Code
|
HCPCS 33011
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Aetna Medicare |
$225.00
|
| Rate for Payer: BCBS Complete |
$180.00
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$292.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.50
|
|
|
PR PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED
|
Professional
|
Both
|
$495.00
|
|
|
Service Code
|
HCPCS 33016
|
| Min. Negotiated Rate |
$198.00 |
| Max. Negotiated Rate |
$414.25 |
| Rate for Payer: Aetna Commercial |
$300.05
|
| Rate for Payer: Aetna Medicare |
$232.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$300.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.44
|
| Rate for Payer: BCBS Complete |
$198.00
|
| Rate for Payer: BCBS MAPPO |
$223.92
|
| Rate for Payer: BCN Medicare Advantage |
$223.92
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cofinity Commercial |
$322.44
|
| Rate for Payer: Cofinity Commercial |
$300.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$223.92
|
| Rate for Payer: Healthscope Commercial |
$414.25
|
| Rate for Payer: Healthscope Commercial |
$358.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$235.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.75
|
| Rate for Payer: Nomi Health Commercial |
$268.70
|
| Rate for Payer: PACE SWMI |
$223.92
|
| Rate for Payer: PHP Medicare Advantage |
$223.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.75
|
| Rate for Payer: Priority Health Medicare |
$223.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$223.92
|
| Rate for Payer: UHC Medicare Advantage |
$223.92
|
|
|
PR PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY
|
Professional
|
Both
|
$2,657.00
|
|
|
Service Code
|
HCPCS 33020
|
| Min. Negotiated Rate |
$795.71 |
| Max. Negotiated Rate |
$1,727.05 |
| Rate for Payer: Aetna Commercial |
$1,066.25
|
| Rate for Payer: Aetna Medicare |
$827.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,066.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,145.82
|
| Rate for Payer: BCBS Complete |
$1,062.80
|
| Rate for Payer: BCBS MAPPO |
$795.71
|
| Rate for Payer: BCN Medicare Advantage |
$795.71
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Cash Price |
$2,125.60
|
| Rate for Payer: Cofinity Commercial |
$1,066.25
|
| Rate for Payer: Cofinity Commercial |
$1,145.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$795.71
|
| Rate for Payer: Healthscope Commercial |
$1,273.14
|
| Rate for Payer: Healthscope Commercial |
$1,472.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$835.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,727.05
|
| Rate for Payer: Nomi Health Commercial |
$954.85
|
| Rate for Payer: PACE SWMI |
$795.71
|
| Rate for Payer: PHP Medicare Advantage |
$795.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,727.05
|
| Rate for Payer: Priority Health Medicare |
$795.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$795.71
|
| Rate for Payer: UHC Medicare Advantage |
$795.71
|
|
|
PR PERI-IMPLANT CAPSULECTOMY BREAST COMPLETE
|
Professional
|
Both
|
$2,152.00
|
|
|
Service Code
|
HCPCS 19371
|
| Min. Negotiated Rate |
$683.82 |
| Max. Negotiated Rate |
$1,398.80 |
| Rate for Payer: Aetna Commercial |
$916.32
|
| Rate for Payer: Aetna Medicare |
$711.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$916.32
|
| Rate for Payer: BCBS Complete |
$860.80
|
| Rate for Payer: BCBS MAPPO |
$683.82
|
| Rate for Payer: BCN Medicare Advantage |
$683.82
|
| Rate for Payer: Cash Price |
$1,721.60
|
| Rate for Payer: Cash Price |
$1,721.60
|
| Rate for Payer: Cofinity Commercial |
$984.70
|
| Rate for Payer: Cofinity Commercial |
$916.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$683.82
|
| Rate for Payer: Healthscope Commercial |
$1,265.07
|
| Rate for Payer: Healthscope Commercial |
$1,094.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,398.80
|
| Rate for Payer: Nomi Health Commercial |
$820.58
|
| Rate for Payer: PACE SWMI |
$683.82
|
| Rate for Payer: PHP Medicare Advantage |
$683.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,398.80
|
| Rate for Payer: Priority Health Medicare |
$683.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$683.82
|
| Rate for Payer: UHC Medicare Advantage |
$683.82
|
|
|
PR PERINEOPLASTY RPR PERINEUM NONOBSTETRICAL SPX
|
Professional
|
Both
|
$916.00
|
|
|
Service Code
|
HCPCS 56810
|
| Min. Negotiated Rate |
$259.54 |
| Max. Negotiated Rate |
$595.40 |
| Rate for Payer: Aetna Commercial |
$347.78
|
| Rate for Payer: Aetna Medicare |
$269.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$373.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$347.78
|
| Rate for Payer: BCBS Complete |
$366.40
|
| Rate for Payer: BCBS MAPPO |
$259.54
|
| Rate for Payer: BCN Medicare Advantage |
$259.54
|
| Rate for Payer: Cash Price |
$732.80
|
| Rate for Payer: Cash Price |
$732.80
|
| Rate for Payer: Cofinity Commercial |
$373.74
|
| Rate for Payer: Cofinity Commercial |
$347.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$259.54
|
| Rate for Payer: Healthscope Commercial |
$415.26
|
| Rate for Payer: Healthscope Commercial |
$480.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$272.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$595.40
|
| Rate for Payer: Nomi Health Commercial |
$311.45
|
| Rate for Payer: PACE SWMI |
$259.54
|
| Rate for Payer: PHP Medicare Advantage |
$259.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$595.40
|
| Rate for Payer: Priority Health Medicare |
$259.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.54
|
| Rate for Payer: UHC Medicare Advantage |
$259.54
|
|
|
PR PERIODIC PREVENTIVE MED ESTABLISHED PATIENT <1Y
|
Professional
|
Both
|
$154.00
|
|
|
Service Code
|
HCPCS 99391
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$100.10 |
| Rate for Payer: Aetna Medicare |
$77.00
|
| Rate for Payer: BCBS Complete |
$61.60
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.10
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 12-17YRS
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 99394
|
| Min. Negotiated Rate |
$66.40 |
| Max. Negotiated Rate |
$107.90 |
| Rate for Payer: Aetna Medicare |
$83.00
|
| Rate for Payer: BCBS Complete |
$66.40
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.90
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 1-4YRS
|
Professional
|
Both
|
$165.00
|
|
|
Service Code
|
HCPCS 99392
|
| Min. Negotiated Rate |
$66.00 |
| Max. Negotiated Rate |
$107.25 |
| Rate for Payer: Aetna Medicare |
$82.50
|
| Rate for Payer: BCBS Complete |
$66.00
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.25
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS
|
Professional
|
Both
|
$169.00
|
|
|
Service Code
|
HCPCS 99395
|
| Min. Negotiated Rate |
$67.60 |
| Max. Negotiated Rate |
$109.85 |
| Rate for Payer: Aetna Medicare |
$84.50
|
| Rate for Payer: BCBS Complete |
$67.60
|
| Rate for Payer: Cash Price |
$135.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.85
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS
|
Professional
|
Both
|
$182.00
|
|
|
Service Code
|
HCPCS 99396
|
| Min. Negotiated Rate |
$72.80 |
| Max. Negotiated Rate |
$118.30 |
| Rate for Payer: Aetna Medicare |
$91.00
|
| Rate for Payer: BCBS Complete |
$72.80
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.30
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 5-11YRS
|
Professional
|
Both
|
$152.00
|
|
|
Service Code
|
HCPCS 99393
|
| Min. Negotiated Rate |
$60.80 |
| Max. Negotiated Rate |
$98.80 |
| Rate for Payer: Aetna Medicare |
$76.00
|
| Rate for Payer: BCBS Complete |
$60.80
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.80
|
|
|
PR PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER
|
Professional
|
Both
|
$196.00
|
|
|
Service Code
|
HCPCS 99397
|
| Min. Negotiated Rate |
$78.40 |
| Max. Negotiated Rate |
$127.40 |
| Rate for Payer: Aetna Medicare |
$98.00
|
| Rate for Payer: BCBS Complete |
$78.40
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.40
|
|
|
PR PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS 93286
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$74.43 |
| Rate for Payer: Aetna Commercial |
$53.91
|
| Rate for Payer: Aetna Medicare |
$41.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.91
|
| Rate for Payer: BCBS Complete |
$27.20
|
| Rate for Payer: BCBS MAPPO |
$40.23
|
| Rate for Payer: BCN Medicare Advantage |
$40.23
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$57.93
|
| Rate for Payer: Cofinity Commercial |
$53.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.23
|
| Rate for Payer: Healthscope Commercial |
$74.43
|
| Rate for Payer: Healthscope Commercial |
$64.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$48.28
|
| Rate for Payer: PACE SWMI |
$40.23
|
| Rate for Payer: PHP Medicare Advantage |
$40.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.20
|
| Rate for Payer: Priority Health Medicare |
$40.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.23
|
| Rate for Payer: UHC Medicare Advantage |
$40.23
|
|
|
PR PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 93287
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$86.67 |
| Rate for Payer: Aetna Commercial |
$62.78
|
| Rate for Payer: Aetna Medicare |
$48.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.78
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS MAPPO |
$46.85
|
| Rate for Payer: BCN Medicare Advantage |
$46.85
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$67.46
|
| Rate for Payer: Cofinity Commercial |
$62.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.85
|
| Rate for Payer: Healthscope Commercial |
$74.96
|
| Rate for Payer: Healthscope Commercial |
$86.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.55
|
| Rate for Payer: Nomi Health Commercial |
$56.22
|
| Rate for Payer: PACE SWMI |
$46.85
|
| Rate for Payer: PHP Medicare Advantage |
$46.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health Medicare |
$46.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.85
|
| Rate for Payer: UHC Medicare Advantage |
$46.85
|
|
|
PR PERIRECTAL INJ SCLEROSING SOLUTION PROLAPSE
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 45520
|
| Min. Negotiated Rate |
$38.04 |
| Max. Negotiated Rate |
$188.50 |
| Rate for Payer: Aetna Commercial |
$50.97
|
| Rate for Payer: Aetna Medicare |
$39.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.97
|
| Rate for Payer: BCBS Complete |
$116.00
|
| Rate for Payer: BCBS MAPPO |
$38.04
|
| Rate for Payer: BCN Medicare Advantage |
$38.04
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$54.78
|
| Rate for Payer: Cofinity Commercial |
$50.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.04
|
| Rate for Payer: Healthscope Commercial |
$70.37
|
| Rate for Payer: Healthscope Commercial |
$60.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.50
|
| Rate for Payer: Nomi Health Commercial |
$45.65
|
| Rate for Payer: PACE SWMI |
$38.04
|
| Rate for Payer: PHP Medicare Advantage |
$38.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.50
|
| Rate for Payer: Priority Health Medicare |
$38.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.04
|
| Rate for Payer: UHC Medicare Advantage |
$38.04
|
|
|
PR PERITONEAL LAVAGE W/WO IMAGING GUIDANCE
|
Professional
|
Both
|
$137.00
|
|
|
Service Code
|
HCPCS 49084
|
| Min. Negotiated Rate |
$54.80 |
| Max. Negotiated Rate |
$193.71 |
| Rate for Payer: Aetna Commercial |
$140.31
|
| Rate for Payer: Aetna Medicare |
$108.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.31
|
| Rate for Payer: BCBS Complete |
$54.80
|
| Rate for Payer: BCBS MAPPO |
$104.71
|
| Rate for Payer: BCN Medicare Advantage |
$104.71
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cofinity Commercial |
$150.78
|
| Rate for Payer: Cofinity Commercial |
$140.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.71
|
| Rate for Payer: Healthscope Commercial |
$167.54
|
| Rate for Payer: Healthscope Commercial |
$193.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.05
|
| Rate for Payer: Nomi Health Commercial |
$125.65
|
| Rate for Payer: PACE SWMI |
$104.71
|
| Rate for Payer: PHP Medicare Advantage |
$104.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.05
|
| Rate for Payer: Priority Health Medicare |
$104.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.71
|
| Rate for Payer: UHC Medicare Advantage |
$104.71
|
|
|
PR PERQ ACCESS & CLOSURE FEM ART FOR DELIVERY NDGFT
|
Professional
|
Both
|
$267.00
|
|
|
Service Code
|
HCPCS 34713
|
| Min. Negotiated Rate |
$106.80 |
| Max. Negotiated Rate |
$218.98 |
| Rate for Payer: Aetna Commercial |
$158.62
|
| Rate for Payer: Aetna Medicare |
$123.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.62
|
| Rate for Payer: BCBS Complete |
$106.80
|
| Rate for Payer: BCBS MAPPO |
$118.37
|
| Rate for Payer: BCN Medicare Advantage |
$118.37
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cofinity Commercial |
$170.45
|
| Rate for Payer: Cofinity Commercial |
$158.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.37
|
| Rate for Payer: Healthscope Commercial |
$218.98
|
| Rate for Payer: Healthscope Commercial |
$189.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.55
|
| Rate for Payer: Nomi Health Commercial |
$142.04
|
| Rate for Payer: PACE SWMI |
$118.37
|
| Rate for Payer: PHP Medicare Advantage |
$118.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.55
|
| Rate for Payer: Priority Health Medicare |
$118.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.37
|
| Rate for Payer: UHC Medicare Advantage |
$118.37
|
|
|
PR PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL
|
Professional
|
Both
|
$1,615.00
|
|
|
Service Code
|
HCPCS 61645
|
| Min. Negotiated Rate |
$646.00 |
| Max. Negotiated Rate |
$1,531.04 |
| Rate for Payer: Aetna Commercial |
$1,108.97
|
| Rate for Payer: Aetna Medicare |
$860.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,191.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,108.97
|
| Rate for Payer: BCBS Complete |
$646.00
|
| Rate for Payer: BCBS MAPPO |
$827.59
|
| Rate for Payer: BCN Medicare Advantage |
$827.59
|
| Rate for Payer: Cash Price |
$1,292.00
|
| Rate for Payer: Cash Price |
$1,292.00
|
| Rate for Payer: Cofinity Commercial |
$1,191.73
|
| Rate for Payer: Cofinity Commercial |
$1,108.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$827.59
|
| Rate for Payer: Healthscope Commercial |
$1,324.14
|
| Rate for Payer: Healthscope Commercial |
$1,531.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$868.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,049.75
|
| Rate for Payer: Nomi Health Commercial |
$993.11
|
| Rate for Payer: PACE SWMI |
$827.59
|
| Rate for Payer: PHP Medicare Advantage |
$827.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,049.75
|
| Rate for Payer: Priority Health Medicare |
$827.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$827.59
|
| Rate for Payer: UHC Medicare Advantage |
$827.59
|
|
|
PR PERQ BALO DILA IC VSPSM EA VSL DIFF VASC TER
|
Professional
|
Both
|
$693.00
|
|
|
Service Code
|
HCPCS 61642
|
| Min. Negotiated Rate |
$277.20 |
| Max. Negotiated Rate |
$450.45 |
| Rate for Payer: Aetna Medicare |
$346.50
|
| Rate for Payer: BCBS Complete |
$277.20
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$450.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.45
|
|
|
PR PERQ BALO DILA IC VSPSM EA VSL SM VASC TER
|
Professional
|
Both
|
$347.00
|
|
|
Service Code
|
HCPCS 61641
|
| Min. Negotiated Rate |
$138.80 |
| Max. Negotiated Rate |
$225.55 |
| Rate for Payer: Aetna Medicare |
$173.50
|
| Rate for Payer: BCBS Complete |
$138.80
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.55
|
|
