|
PR PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$339.00
|
|
|
Service Code
|
HCPCS 45307
|
| Min. Negotiated Rate |
$64.75 |
| Max. Negotiated Rate |
$17,831.00 |
| Rate for Payer: Aetna Commercial |
$130.76
|
| Rate for Payer: Aetna Medicare |
$101.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.52
|
| Rate for Payer: BCBS Complete |
$67.99
|
| Rate for Payer: BCBS MAPPO |
$97.58
|
| Rate for Payer: BCBS Trust/PPO |
$854.26
|
| Rate for Payer: BCN Commercial |
$316.66
|
| Rate for Payer: BCN Medicare Advantage |
$97.58
|
| Rate for Payer: Cash Price |
$271.20
|
| Rate for Payer: Cash Price |
$271.20
|
| Rate for Payer: Cofinity Commercial |
$140.52
|
| Rate for Payer: Cofinity Commercial |
$130.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.58
|
| Rate for Payer: Healthscope Commercial |
$180.52
|
| Rate for Payer: Healthscope Commercial |
$156.13
|
| Rate for Payer: Mclaren Medicaid |
$64.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.46
|
| Rate for Payer: Meridian Medicaid |
$67.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,831.00
|
| Rate for Payer: Nomi Health Commercial |
$117.10
|
| Rate for Payer: PACE SWMI |
$97.58
|
| Rate for Payer: PHP Medicare Advantage |
$97.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.58
|
| Rate for Payer: Priority Health Medicare |
$97.58
|
| Rate for Payer: Priority Health Narrow Network |
$179.58
|
| Rate for Payer: Priority Health SBD |
$179.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.58
|
| Rate for Payer: UHC Exchange |
$163.06
|
| Rate for Payer: UHC Medicare Advantage |
$97.58
|
| Rate for Payer: UHCCP Medicaid |
$64.75
|
|
|
PR PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 95115
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$1,398.00 |
| Rate for Payer: Aetna Commercial |
$12.74
|
| Rate for Payer: Aetna Medicare |
$9.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.69
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$9.51
|
| Rate for Payer: BCBS Trust/PPO |
$432.68
|
| Rate for Payer: BCN Commercial |
$14.66
|
| Rate for Payer: BCN Medicare Advantage |
$9.51
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Cofinity Commercial |
$12.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.51
|
| Rate for Payer: Healthscope Commercial |
$15.22
|
| Rate for Payer: Healthscope Commercial |
$17.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,398.00
|
| Rate for Payer: Nomi Health Commercial |
$11.41
|
| Rate for Payer: PACE SWMI |
$9.51
|
| Rate for Payer: PHP Medicare Advantage |
$9.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.72
|
| Rate for Payer: Priority Health Medicare |
$9.51
|
| Rate for Payer: Priority Health Narrow Network |
$13.72
|
| Rate for Payer: Priority Health SBD |
$13.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.51
|
| Rate for Payer: UHC Exchange |
$18.12
|
| Rate for Payer: UHC Medicare Advantage |
$9.51
|
|
|
PR PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 95117
|
| Min. Negotiated Rate |
$10.99 |
| Max. Negotiated Rate |
$1,629.00 |
| Rate for Payer: Aetna Commercial |
$14.73
|
| Rate for Payer: Aetna Medicare |
$11.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.83
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$10.99
|
| Rate for Payer: BCBS Trust/PPO |
$446.94
|
| Rate for Payer: BCN Commercial |
$17.10
|
| Rate for Payer: BCN Medicare Advantage |
$10.99
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$15.83
|
| Rate for Payer: Cofinity Commercial |
$14.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.99
|
| Rate for Payer: Healthscope Commercial |
$17.58
|
| Rate for Payer: Healthscope Commercial |
$20.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,629.00
|
| Rate for Payer: Nomi Health Commercial |
$13.19
|
| Rate for Payer: PACE SWMI |
$10.99
|
| Rate for Payer: PHP Medicare Advantage |
$10.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.65
|
| Rate for Payer: Priority Health Medicare |
$10.99
|
| Rate for Payer: Priority Health Narrow Network |
$16.65
|
| Rate for Payer: Priority Health SBD |
$16.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.99
|
| Rate for Payer: UHC Exchange |
$23.52
|
| Rate for Payer: UHC Medicare Advantage |
$10.99
|
|
|
PR PROG DEVICE EVAL IN PERSON LEADLESS PM SYSTEM
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 0389T
|
| Min. Negotiated Rate |
$36.80 |
| Max. Negotiated Rate |
$59.80 |
| Rate for Payer: Aetna Medicare |
$46.00
|
| Rate for Payer: BCBS Complete |
$36.80
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
|
|
PR PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 93280
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$11,394.00 |
| Rate for Payer: Aetna Commercial |
$94.93
|
| Rate for Payer: Aetna Medicare |
$73.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.93
|
| Rate for Payer: BCBS Complete |
$24.15
|
| Rate for Payer: BCBS MAPPO |
$70.84
|
| Rate for Payer: BCBS Trust/PPO |
$707.92
|
| Rate for Payer: BCN Commercial |
$116.31
|
| Rate for Payer: BCN Medicare Advantage |
$70.84
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cofinity Commercial |
$94.93
|
| Rate for Payer: Cofinity Commercial |
$102.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.84
|
| Rate for Payer: Healthscope Commercial |
$113.34
|
| Rate for Payer: Healthscope Commercial |
$131.05
|
| Rate for Payer: Mclaren Medicaid |
$23.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.38
|
| Rate for Payer: Meridian Medicaid |
$24.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,394.00
|
| Rate for Payer: Nomi Health Commercial |
$85.01
|
| Rate for Payer: PACE SWMI |
$70.84
|
| Rate for Payer: PHP Medicare Advantage |
$70.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.65
|
| Rate for Payer: Priority Health Medicare |
$70.84
|
| Rate for Payer: Priority Health Narrow Network |
$110.65
|
| Rate for Payer: Priority Health SBD |
$50.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.84
|
| Rate for Payer: UHC Medicare Advantage |
$70.84
|
| Rate for Payer: UHCCP Medicaid |
$23.00
|
|
|
PR PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER
|
Professional
|
Both
|
$230.00
|
|
|
Service Code
|
HCPCS 93281
|
| Min. Negotiated Rate |
$25.77 |
| Max. Negotiated Rate |
$12,189.00 |
| Rate for Payer: Aetna Commercial |
$101.26
|
| Rate for Payer: Aetna Medicare |
$78.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.82
|
| Rate for Payer: BCBS Complete |
$27.06
|
| Rate for Payer: BCBS MAPPO |
$75.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,457.58
|
| Rate for Payer: BCN Commercial |
$124.13
|
| Rate for Payer: BCN Medicare Advantage |
$75.57
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cofinity Commercial |
$108.82
|
| Rate for Payer: Cofinity Commercial |
$101.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.57
|
| Rate for Payer: Healthscope Commercial |
$120.91
|
| Rate for Payer: Healthscope Commercial |
$139.80
|
| Rate for Payer: Mclaren Medicaid |
$25.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.35
|
| Rate for Payer: Meridian Medicaid |
$27.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,189.00
|
| Rate for Payer: Nomi Health Commercial |
$90.68
|
| Rate for Payer: PACE SWMI |
$75.57
|
| Rate for Payer: PHP Medicare Advantage |
$75.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.71
|
| Rate for Payer: Priority Health Medicare |
$75.57
|
| Rate for Payer: Priority Health Narrow Network |
$117.71
|
| Rate for Payer: Priority Health SBD |
$56.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.57
|
| Rate for Payer: UHC Medicare Advantage |
$75.57
|
| Rate for Payer: UHCCP Medicaid |
$25.77
|
|
|
PR PROGRAMMED STIMJ & PACG AFTER IV DRUG INFUSION
|
Professional
|
Both
|
$243.00
|
|
|
Service Code
|
HCPCS 93623
|
| Min. Negotiated Rate |
$34.08 |
| Max. Negotiated Rate |
$15,686.00 |
| Rate for Payer: Aetna Commercial |
$217.76
|
| Rate for Payer: Aetna Commercial |
$217.76
|
| Rate for Payer: Aetna Medicare |
$121.50
|
| Rate for Payer: Aetna Medicare |
$166.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.76
|
| Rate for Payer: BCBS Complete |
$35.78
|
| Rate for Payer: BCBS Complete |
$35.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,500.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,500.37
|
| Rate for Payer: BCN Commercial |
$1,642.40
|
| Rate for Payer: BCN Commercial |
$1,642.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Mclaren Medicaid |
$34.08
|
| Rate for Payer: Mclaren Medicaid |
$34.08
|
| Rate for Payer: Meridian Medicaid |
$35.78
|
| Rate for Payer: Meridian Medicaid |
$35.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,686.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,686.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.30
|
| Rate for Payer: Priority Health Narrow Network |
$124.30
|
| Rate for Payer: Priority Health Narrow Network |
$124.30
|
| Rate for Payer: Priority Health SBD |
$93.23
|
| Rate for Payer: Priority Health SBD |
$93.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$535.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$535.03
|
| Rate for Payer: UHC Exchange |
$535.03
|
| Rate for Payer: UHC Exchange |
$535.03
|
| Rate for Payer: UHCCP Medicaid |
$34.08
|
| Rate for Payer: UHCCP Medicaid |
$34.08
|
|
|
PR PRO HEALTH BACK SCREEN
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 99212
|
| Hospital Charge Code |
51000022
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$88.72 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$88.72
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$88.72
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.27
|
|
|
PR PRO HEALTH BACK SCREEN
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 99212
|
| Hospital Charge Code |
51000022
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$32.13 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health SBD |
$32.13
|
|
|
PR PRO HEALTH FIT FOR DUTY EXAM
|
Facility
|
OP
|
$229.50
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51000038
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$91.80 |
| Max. Negotiated Rate |
$208.46 |
| Rate for Payer: Aetna Commercial |
$195.08
|
| Rate for Payer: Aetna Medicare |
$114.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.18
|
| Rate for Payer: BCBS Complete |
$91.80
|
| Rate for Payer: BCBS Trust/PPO |
$208.46
|
| Rate for Payer: BCN Commercial |
$208.46
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$160.65
|
| Rate for Payer: Cofinity Commercial |
$197.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$160.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$206.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.08
|
| Rate for Payer: PHP Commercial |
$195.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.18
|
| Rate for Payer: Priority Health SBD |
$144.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.82
|
|
|
PR PRO HEALTH FIT FOR DUTY EXAM
|
Facility
|
IP
|
$229.50
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51000038
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$144.58 |
| Max. Negotiated Rate |
$206.55 |
| Rate for Payer: Aetna Commercial |
$195.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.18
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$160.65
|
| Rate for Payer: Cofinity Commercial |
$197.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$160.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$206.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.08
|
| Rate for Payer: PHP Commercial |
$195.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.18
|
| Rate for Payer: Priority Health SBD |
$144.58
|
|
|
PR PRO HEALTH LIFT TEST
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 99212
|
| Hospital Charge Code |
51000023
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$88.72 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$88.72
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$88.72
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.27
|
|
|
PR PRO HEALTH LIFT TEST
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 99212
|
| Hospital Charge Code |
51000023
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$32.13 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health SBD |
$32.13
|
|
|
PR PRO HEALTH NURSE VISIT
|
Facility
|
OP
|
$32.64
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000017
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$9.21 |
| Max. Negotiated Rate |
$49.38 |
| Rate for Payer: Aetna Commercial |
$27.74
|
| Rate for Payer: Aetna Medicare |
$16.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.22
|
| Rate for Payer: BCBS Complete |
$13.06
|
| Rate for Payer: BCBS Trust/PPO |
$49.38
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$49.38
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$29.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.74
|
| Rate for Payer: PHP Commercial |
$27.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.22
|
| Rate for Payer: Priority Health SBD |
$20.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.21
|
|
|
PR PRO HEALTH NURSE VISIT
|
Facility
|
IP
|
$32.64
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000017
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$20.56 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Aetna Commercial |
$27.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.22
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$29.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.74
|
| Rate for Payer: PHP Commercial |
$27.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.22
|
| Rate for Payer: Priority Health SBD |
$20.56
|
|
|
PR PRO HEALTH PHYSICAL AGILITY TEST
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51000028
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$44.98 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.41
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$49.98
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health SBD |
$44.98
|
|
|
PR PRO HEALTH PHYSICAL AGILITY TEST
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51000028
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$28.56 |
| Max. Negotiated Rate |
$119.52 |
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna Medicare |
$35.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.41
|
| Rate for Payer: BCBS Complete |
$28.56
|
| Rate for Payer: BCBS Trust/PPO |
$119.52
|
| Rate for Payer: BCCCP Commercial |
$87.68
|
| Rate for Payer: BCN Commercial |
$119.52
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$49.98
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health SBD |
$44.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.42
|
|
|
PR PRO HEALTH VISION TESTING
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000018
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$9.21 |
| Max. Negotiated Rate |
$49.38 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$12.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: BCBS Complete |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$49.38
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$49.38
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.21
|
|
|
PR PRO HEALTH VISION TESTING
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000018
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$16.06 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: Priority Health SBD |
$16.06
|
|
|
PR PROHEALTH WORKSTATION EVAL
|
Facility
|
OP
|
$102.00
|
|
| Hospital Charge Code |
98300182
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: Aetna Medicare |
$51.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.30
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$71.40
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.70
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health SBD |
$64.26
|
|
|
PR PROHEALTH WORKSTATION EVAL
|
Facility
|
IP
|
$102.00
|
|
| Hospital Charge Code |
98300182
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$64.26 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.30
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Cofinity Commercial |
$71.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.70
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health SBD |
$64.26
|
|
|
PR PROLNG E/M BEFORE&/AFTER DIR CARE EA 30 MINUTES
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 99359
|
| Min. Negotiated Rate |
$48.40 |
| Max. Negotiated Rate |
$6,279.00 |
| Rate for Payer: Aetna Commercial |
$52.40
|
| Rate for Payer: Aetna Medicare |
$60.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.40
|
| Rate for Payer: BCBS Complete |
$48.40
|
| Rate for Payer: BCBS Trust/PPO |
$295.85
|
| Rate for Payer: BCN Commercial |
$62.06
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,279.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.91
|
| Rate for Payer: Priority Health Narrow Network |
$48.91
|
| Rate for Payer: Priority Health SBD |
$48.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.81
|
| Rate for Payer: UHC Exchange |
$60.81
|
|
|
PR PROLNG E/M SVC BEFORE&/AFTER DIR PT CARE 1ST HR
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 99358
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$13,422.00 |
| Rate for Payer: Aetna Commercial |
$109.68
|
| Rate for Payer: Aetna Medicare |
$121.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.68
|
| Rate for Payer: BCBS Complete |
$96.80
|
| Rate for Payer: BCBS Trust/PPO |
$147.73
|
| Rate for Payer: BCN Commercial |
$133.41
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,422.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.12
|
| Rate for Payer: Priority Health Narrow Network |
$117.12
|
| Rate for Payer: Priority Health SBD |
$117.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.61
|
| Rate for Payer: UHC Exchange |
$121.61
|
|
|
PR PROLONGED EXTRACORPOREAL CIRCULATION INIT DAY
|
Professional
|
Both
|
$2,772.00
|
|
|
Service Code
|
HCPCS 33960
|
| Min. Negotiated Rate |
$1,108.80 |
| Max. Negotiated Rate |
$1,801.80 |
| Rate for Payer: Aetna Medicare |
$1,386.00
|
| Rate for Payer: BCBS Complete |
$1,108.80
|
| Rate for Payer: Cash Price |
$2,217.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,801.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,801.80
|
|
|
PR PROLONGED INPATIENT/OBSERVATION EM SVC EA 15 MIN
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 99418
|
| Min. Negotiated Rate |
$24.92 |
| Max. Negotiated Rate |
$5,772.00 |
| Rate for Payer: Aetna Commercial |
$38.86
|
| Rate for Payer: Aetna Medicare |
$39.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.86
|
| Rate for Payer: BCBS Complete |
$26.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,631.44
|
| Rate for Payer: BCN Commercial |
$56.68
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Mclaren Medicaid |
$24.92
|
| Rate for Payer: Meridian Medicaid |
$26.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,772.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.50
|
| Rate for Payer: Priority Health Narrow Network |
$52.50
|
| Rate for Payer: Priority Health SBD |
$52.50
|
| Rate for Payer: UHCCP Medicaid |
$24.92
|
|
