|
PR ANES ALL OPEN PX UPR ENDS TIBIA FIBULA&/PATELLA
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS 01392
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$2.00
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.00
|
|
|
PR ANES ALL PX INTEG MUSC&NRV HEAD NCK&PST TRNK NOS
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS 00300
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$2.50
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.75
|
|
|
PR ANES ALL PX NRV MUSC TDN FASCIA&BURSAE KNEE&/POP
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS 01320
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$2.00
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.00
|
|
|
PR ANES ALL PX NRV MUSC TDN FASCIA&BURSAE UPPER LEG
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS 01250
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$2.00
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.00
|
|
|
PR ANES ALL PX NRV MUSC TDN FSCA&BRS F/ARM WRST&HND
|
Professional
|
Both
|
$3.00
|
|
|
Service Code
|
HCPCS 01810
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$1.50
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.25
|
|
|
PR ANES ALL PX NRV MUSC TND FSCA&BRS SHOULDER&AX
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS 01610
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$2.50
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.75
|
|
|
PR ANES ALL PX VEINS UPR LEG INCLUDING EXPLORATION
|
Professional
|
Both
|
$3.00
|
|
|
Service Code
|
HCPCS 01260
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$1.50
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.25
|
|
|
PR ANES ARTHRS/NDSC DSTL RADIUS ULNA/WRIST/HAND NOS
|
Professional
|
Both
|
$3.00
|
|
|
Service Code
|
HCPCS 01830
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$1.50
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.25
|
|
|
PR ANES BONE MARROW ASPIR&/BX ANT/PST ILIAC CREST
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS 01112
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$2.50
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.75
|
|
|
PR ANES C-CATHJ W/C ANGIOGRAPHY & VENTRICULOGRAPHY
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS 01920
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$3.50
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.25
|
|
|
PR ANES C DLVR FLWG NEURAXIAL LABOR ANALG/ANES
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS 01968
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$1.00
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.50
|
|
|
PR ANES CESARN HYST FLWG NEURAXIAL LABOR ANALG/ANES
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS 01969
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$2.50
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.75
|
|
|
PR ANES CLOSED PX SYMPHYSIS PUBIS/SACROILIAC JOINT
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS 01160
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$2.00
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.00
|
|
|
PR ANES CLSD CH PX MEDIASTSC&THRSC W/1 LUNG VNTJ
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 00529
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
|
|
PR ANES CLSD CH PX MEDIASTSC&THRSC W/O 1 LUNG VNTJ
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 00528
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$4.00
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.00
|
|
|
PR ANES CLSD PX HUMRL H&N STRNCLAV ACROMCLAV&SHO JT
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS 01620
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$2.00
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.00
|
|
|
PR ANES DIAGNOSTIC/THERAPEUTIC LUMBAR PUNCTURE
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS 00635
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$2.00
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.00
|
|
|
PR ANES DIRECT CABG W/O PUMP OXYGENATOR
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS 00566
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$13.00
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.50
|
|
|
PR ANES DIRECT CABG W/PUMP OXYGENATOR
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 00567
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$9.00
|
| Rate for Payer: BCBS Complete |
$7.20
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.50
|
|
|
PR ANES DX/THER NERVE BLOCK&INJECTION PRONE POS
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS 01992
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$2.50
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.75
|
|
|
PR ANES DX/THER NRV BLK&NJX OTH/THN PRONE POS
|
Professional
|
Both
|
$3.00
|
|
|
Service Code
|
HCPCS 01991
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$1.50
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.25
|
|
|
PR ANES ESOPH THYR LARX TRCH&LYMPH NCK NDL BX THYR
|
Professional
|
Both
|
$3.00
|
|
|
Service Code
|
HCPCS 00322
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$1.50
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.25
|
|
|
PR ANES EXTRAPERITONEAL LWR ABD W/URINARY TRACT NOS
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS 00860
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$3.00
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.50
|
|
|
PR ANES FOREARM WRIST/HAND CAST APPL RMVL/REPAIR
|
Professional
|
Both
|
$3.00
|
|
|
Service Code
|
HCPCS 01860
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$1.50
|
| Rate for Payer: BCBS Complete |
$1.20
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.25
|
|
|
PR ANES HEART TRANSPLANT/HEART/LUNG TRANSPLANT
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS 00580
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Medicare |
$10.00
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.00
|
|