|
PR NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 20560
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Aetna Commercial |
$22.07
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$37.50
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.47
|
| Rate for Payer: Priority Health Narrow Network |
$22.47
|
| Rate for Payer: Priority Health SBD |
$22.47
|
|
|
PR NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 20561
|
| Min. Negotiated Rate |
$29.60 |
| Max. Negotiated Rate |
$51.80 |
| Rate for Payer: Aetna Commercial |
$32.61
|
| Rate for Payer: BCBS Complete |
$29.60
|
| Rate for Payer: BCBS Trust/PPO |
$37.50
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.71
|
| Rate for Payer: Priority Health Narrow Network |
$33.71
|
| Rate for Payer: Priority Health SBD |
$33.71
|
|
|
PR NEEDLE OCULOGRAPHY 1/ XOC MUSC 1/BOTH EYE W/I&R
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 92265
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$1,168.07 |
| Rate for Payer: Aetna Commercial |
$91.63
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,168.07
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.78
|
| Rate for Payer: Priority Health Narrow Network |
$49.78
|
| Rate for Payer: Priority Health SBD |
$103.58
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 97605
|
| Min. Negotiated Rate |
$15.34 |
| Max. Negotiated Rate |
$796.68 |
| Rate for Payer: Aetna Commercial |
$27.96
|
| Rate for Payer: BCBS Complete |
$16.11
|
| Rate for Payer: BCBS Trust/PPO |
$796.68
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Mclaren Medicaid |
$15.34
|
| Rate for Payer: Meridian Medicaid |
$16.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.51
|
| Rate for Payer: Priority Health Narrow Network |
$34.51
|
| Rate for Payer: Priority Health SBD |
$34.51
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 97606
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$1,160.68 |
| Rate for Payer: Aetna Commercial |
$30.62
|
| Rate for Payer: BCBS Complete |
$17.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,160.68
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Mclaren Medicaid |
$16.83
|
| Rate for Payer: Meridian Medicaid |
$17.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.30
|
| Rate for Payer: Priority Health Narrow Network |
$37.30
|
| Rate for Payer: Priority Health SBD |
$37.30
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 97607
|
| Min. Negotiated Rate |
$13.42 |
| Max. Negotiated Rate |
$768.68 |
| Rate for Payer: Aetna Commercial |
$25.52
|
| Rate for Payer: BCBS Complete |
$14.09
|
| Rate for Payer: BCBS Trust/PPO |
$768.68
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Mclaren Medicaid |
$13.42
|
| Rate for Payer: Meridian Medicaid |
$14.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.82
|
| Rate for Payer: Priority Health Narrow Network |
$35.82
|
| Rate for Payer: Priority Health SBD |
$35.82
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 97608
|
| Min. Negotiated Rate |
$15.76 |
| Max. Negotiated Rate |
$1,073.51 |
| Rate for Payer: Aetna Commercial |
$28.18
|
| Rate for Payer: BCBS Complete |
$16.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,073.51
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Mclaren Medicaid |
$15.76
|
| Rate for Payer: Meridian Medicaid |
$16.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.48
|
| Rate for Payer: Priority Health Narrow Network |
$39.48
|
| Rate for Payer: Priority Health SBD |
$39.48
|
|
|
PR NEPHRECTOMY PARTIAL
|
Professional
|
Both
|
$2,480.00
|
|
|
Service Code
|
HCPCS 50240
|
| Min. Negotiated Rate |
$841.99 |
| Max. Negotiated Rate |
$3,703.38 |
| Rate for Payer: Aetna Commercial |
$1,700.84
|
| Rate for Payer: BCBS Complete |
$884.09
|
| Rate for Payer: BCBS Trust/PPO |
$3,703.38
|
| Rate for Payer: Cash Price |
$1,984.00
|
| Rate for Payer: Cash Price |
$1,984.00
|
| Rate for Payer: Mclaren Medicaid |
$841.99
|
| Rate for Payer: Meridian Medicaid |
$884.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$841.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,736.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,108.48
|
| Rate for Payer: Priority Health Narrow Network |
$2,108.48
|
| Rate for Payer: Priority Health SBD |
$2,108.48
|
|
|
PR NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN
|
Professional
|
Both
|
$2,753.00
|
|
|
Service Code
|
HCPCS 50236
|
| Min. Negotiated Rate |
$925.91 |
| Max. Negotiated Rate |
$5,250.25 |
| Rate for Payer: Aetna Commercial |
$1,881.80
|
| Rate for Payer: BCBS Complete |
$972.21
|
| Rate for Payer: BCBS Trust/PPO |
$5,250.25
|
| Rate for Payer: Cash Price |
$2,202.40
|
| Rate for Payer: Cash Price |
$2,202.40
|
| Rate for Payer: Mclaren Medicaid |
$925.91
|
| Rate for Payer: Meridian Medicaid |
$972.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$925.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,927.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,325.71
|
| Rate for Payer: Priority Health Narrow Network |
$2,325.71
|
| Rate for Payer: Priority Health SBD |
$2,325.71
|
|
|
PR NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ
|
Professional
|
Both
|
$3,632.00
|
|
|
Service Code
|
HCPCS 50220
|
| Min. Negotiated Rate |
$669.03 |
| Max. Negotiated Rate |
$4,223.76 |
| Rate for Payer: Aetna Commercial |
$1,352.45
|
| Rate for Payer: BCBS Complete |
$702.48
|
| Rate for Payer: BCBS Trust/PPO |
$4,223.76
|
| Rate for Payer: Cash Price |
$2,905.60
|
| Rate for Payer: Cash Price |
$2,905.60
|
| Rate for Payer: Mclaren Medicaid |
$669.03
|
| Rate for Payer: Meridian Medicaid |
$702.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$669.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,542.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,682.14
|
| Rate for Payer: Priority Health Narrow Network |
$1,682.14
|
| Rate for Payer: Priority Health SBD |
$1,682.14
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD
|
Professional
|
Both
|
$4,298.00
|
|
|
Service Code
|
HCPCS 50230
|
| Min. Negotiated Rate |
$809.83 |
| Max. Negotiated Rate |
$3,770.48 |
| Rate for Payer: Aetna Commercial |
$1,645.84
|
| Rate for Payer: BCBS Complete |
$850.32
|
| Rate for Payer: BCBS Trust/PPO |
$3,770.48
|
| Rate for Payer: Cash Price |
$3,438.40
|
| Rate for Payer: Cash Price |
$3,438.40
|
| Rate for Payer: Mclaren Medicaid |
$809.83
|
| Rate for Payer: Meridian Medicaid |
$850.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$809.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,008.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,034.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,034.44
|
| Rate for Payer: Priority Health SBD |
$2,034.44
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL
|
Professional
|
Both
|
$3,386.00
|
|
|
Service Code
|
HCPCS 50225
|
| Min. Negotiated Rate |
$768.50 |
| Max. Negotiated Rate |
$3,687.01 |
| Rate for Payer: Aetna Commercial |
$1,542.79
|
| Rate for Payer: BCBS Complete |
$806.92
|
| Rate for Payer: BCBS Trust/PPO |
$3,687.01
|
| Rate for Payer: Cash Price |
$2,708.80
|
| Rate for Payer: Cash Price |
$2,708.80
|
| Rate for Payer: Mclaren Medicaid |
$768.50
|
| Rate for Payer: Meridian Medicaid |
$806.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$768.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,370.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,918.28
|
| Rate for Payer: Priority Health Narrow Network |
$1,918.28
|
| Rate for Payer: Priority Health SBD |
$1,918.28
|
|
|
PR NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC
|
Professional
|
Both
|
$2,439.00
|
|
|
Service Code
|
HCPCS 50234
|
| Min. Negotiated Rate |
$823.25 |
| Max. Negotiated Rate |
$4,336.29 |
| Rate for Payer: Aetna Commercial |
$1,674.08
|
| Rate for Payer: BCBS Complete |
$864.41
|
| Rate for Payer: BCBS Trust/PPO |
$4,336.29
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Mclaren Medicaid |
$823.25
|
| Rate for Payer: Meridian Medicaid |
$864.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$823.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,707.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,072.27
|
| Rate for Payer: Priority Health Narrow Network |
$2,072.27
|
| Rate for Payer: Priority Health SBD |
$2,072.27
|
|
|
PR NEPHROLITHOTOMY REMOVAL CALCULUS
|
Professional
|
Both
|
$2,024.00
|
|
|
Service Code
|
HCPCS 50060
|
| Min. Negotiated Rate |
$721.64 |
| Max. Negotiated Rate |
$2,591.84 |
| Rate for Payer: Aetna Commercial |
$1,462.76
|
| Rate for Payer: BCBS Complete |
$757.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,591.84
|
| Rate for Payer: Cash Price |
$1,619.20
|
| Rate for Payer: Cash Price |
$1,619.20
|
| Rate for Payer: Mclaren Medicaid |
$721.64
|
| Rate for Payer: Meridian Medicaid |
$757.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,416.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,809.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,809.65
|
| Rate for Payer: Priority Health SBD |
$1,809.65
|
|
|
PR NEPHROLITHOTOMY RMVL LARGE STAGHORN CALCULUS
|
Professional
|
Both
|
$3,347.00
|
|
|
Service Code
|
HCPCS 50075
|
| Min. Negotiated Rate |
$921.23 |
| Max. Negotiated Rate |
$2,775.16 |
| Rate for Payer: Aetna Commercial |
$1,870.27
|
| Rate for Payer: BCBS Complete |
$967.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,775.16
|
| Rate for Payer: Cash Price |
$2,677.60
|
| Rate for Payer: Cash Price |
$2,677.60
|
| Rate for Payer: Mclaren Medicaid |
$921.23
|
| Rate for Payer: Meridian Medicaid |
$967.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$921.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,342.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,311.64
|
| Rate for Payer: Priority Health Narrow Network |
$2,311.64
|
| Rate for Payer: Priority Health SBD |
$2,311.64
|
|
|
PR NEPHRORRHAPHY SUTURE KIDNEY WOUND/INJURY
|
Professional
|
Both
|
$2,260.00
|
|
|
Service Code
|
HCPCS 50500
|
| Min. Negotiated Rate |
$824.10 |
| Max. Negotiated Rate |
$2,011.75 |
| Rate for Payer: Aetna Commercial |
$1,602.20
|
| Rate for Payer: BCBS Complete |
$865.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,989.58
|
| Rate for Payer: Cash Price |
$1,808.00
|
| Rate for Payer: Cash Price |
$1,808.00
|
| Rate for Payer: Mclaren Medicaid |
$824.10
|
| Rate for Payer: Meridian Medicaid |
$865.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$824.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,582.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,011.75
|
| Rate for Payer: Priority Health Narrow Network |
$2,011.75
|
| Rate for Payer: Priority Health SBD |
$2,011.75
|
|
|
PR NEPHROSTOMY NEPHROTOMY W/DRAINAGE
|
Professional
|
Both
|
$1,730.00
|
|
|
Service Code
|
HCPCS 50040
|
| Min. Negotiated Rate |
$587.67 |
| Max. Negotiated Rate |
$3,134.93 |
| Rate for Payer: Aetna Commercial |
$1,185.26
|
| Rate for Payer: BCBS Complete |
$617.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,134.93
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Mclaren Medicaid |
$587.67
|
| Rate for Payer: Meridian Medicaid |
$617.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$587.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,211.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,473.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,473.02
|
| Rate for Payer: Priority Health SBD |
$1,473.02
|
|
|
PR NERVE CONDUCTION STUDIES 11-12 STUDIES
|
Professional
|
Both
|
$313.00
|
|
|
Service Code
|
HCPCS 95912
|
| Min. Negotiated Rate |
$124.87 |
| Max. Negotiated Rate |
$8,557.53 |
| Rate for Payer: Aetna Commercial |
$283.19
|
| Rate for Payer: Aetna Commercial |
$283.19
|
| Rate for Payer: BCBS Complete |
$208.80
|
| Rate for Payer: BCBS Complete |
$125.20
|
| Rate for Payer: BCBS Trust/PPO |
$8,557.53
|
| Rate for Payer: BCBS Trust/PPO |
$8,557.53
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.87
|
| Rate for Payer: Priority Health Narrow Network |
$124.87
|
| Rate for Payer: Priority Health Narrow Network |
$124.87
|
| Rate for Payer: Priority Health SBD |
$331.02
|
| Rate for Payer: Priority Health SBD |
$331.02
|
|
|
PR NERVE CONDUCTION STUDIES 1-2 STUDIES
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 95907
|
| Min. Negotiated Rate |
$50.75 |
| Max. Negotiated Rate |
$1,173.88 |
| Rate for Payer: Aetna Commercial |
$102.58
|
| Rate for Payer: Aetna Commercial |
$102.58
|
| Rate for Payer: BCBS Complete |
$66.80
|
| Rate for Payer: BCBS Complete |
$35.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,173.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,173.88
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.75
|
| Rate for Payer: Priority Health Narrow Network |
$50.75
|
| Rate for Payer: Priority Health Narrow Network |
$50.75
|
| Rate for Payer: Priority Health SBD |
$119.92
|
| Rate for Payer: Priority Health SBD |
$119.92
|
|
|
PR NERVE CONDUCTION STUDIES 13/> STUDIES
|
Professional
|
Both
|
$860.00
|
|
|
Service Code
|
HCPCS 95913
|
| Min. Negotiated Rate |
$137.88 |
| Max. Negotiated Rate |
$602.00 |
| Rate for Payer: Aetna Commercial |
$328.98
|
| Rate for Payer: Aetna Commercial |
$328.98
|
| Rate for Payer: BCBS Complete |
$344.00
|
| Rate for Payer: BCBS Complete |
$209.60
|
| Rate for Payer: BCBS Trust/PPO |
$214.87
|
| Rate for Payer: BCBS Trust/PPO |
$214.87
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Cash Price |
$419.20
|
| Rate for Payer: Cash Price |
$419.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$366.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$602.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.88
|
| Rate for Payer: Priority Health Narrow Network |
$137.88
|
| Rate for Payer: Priority Health Narrow Network |
$137.88
|
| Rate for Payer: Priority Health SBD |
$382.22
|
| Rate for Payer: Priority Health SBD |
$382.22
|
|
|
PR NERVE CONDUCTION STUDIES 3-4 STUDIES
|
Professional
|
Both
|
$214.00
|
|
|
Service Code
|
HCPCS 95908
|
| Min. Negotiated Rate |
$62.88 |
| Max. Negotiated Rate |
$1,235.69 |
| Rate for Payer: Aetna Commercial |
$129.47
|
| Rate for Payer: Aetna Commercial |
$129.47
|
| Rate for Payer: BCBS Complete |
$85.60
|
| Rate for Payer: BCBS Complete |
$132.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,235.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,235.69
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.88
|
| Rate for Payer: Priority Health Narrow Network |
$62.88
|
| Rate for Payer: Priority Health Narrow Network |
$62.88
|
| Rate for Payer: Priority Health SBD |
$149.12
|
| Rate for Payer: Priority Health SBD |
$149.12
|
|
|
PR NERVE CONDUCTION STUDIES 5-6 STUDIES
|
Professional
|
Both
|
$398.00
|
|
|
Service Code
|
HCPCS 95909
|
| Min. Negotiated Rate |
$75.46 |
| Max. Negotiated Rate |
$1,003.24 |
| Rate for Payer: Aetna Commercial |
$154.55
|
| Rate for Payer: Aetna Commercial |
$154.55
|
| Rate for Payer: BCBS Complete |
$105.60
|
| Rate for Payer: BCBS Complete |
$159.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.24
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.46
|
| Rate for Payer: Priority Health Narrow Network |
$75.46
|
| Rate for Payer: Priority Health Narrow Network |
$75.46
|
| Rate for Payer: Priority Health SBD |
$179.21
|
| Rate for Payer: Priority Health SBD |
$179.21
|
|
|
PR NERVE CONDUCTION STUDIES 7-8 STUDIES
|
Professional
|
Both
|
$374.00
|
|
|
Service Code
|
HCPCS 95910
|
| Min. Negotiated Rate |
$96.57 |
| Max. Negotiated Rate |
$1,982.71 |
| Rate for Payer: Aetna Commercial |
$203.39
|
| Rate for Payer: Aetna Commercial |
$203.39
|
| Rate for Payer: BCBS Complete |
$149.60
|
| Rate for Payer: BCBS Complete |
$209.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,982.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,982.71
|
| Rate for Payer: Cash Price |
$419.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cash Price |
$419.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$366.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.57
|
| Rate for Payer: Priority Health Narrow Network |
$96.57
|
| Rate for Payer: Priority Health Narrow Network |
$96.57
|
| Rate for Payer: Priority Health SBD |
$234.45
|
| Rate for Payer: Priority Health SBD |
$234.45
|
|
|
PR NERVE CONDUCTION STUDIES 9-10 STUDIES
|
Professional
|
Both
|
$634.00
|
|
|
Service Code
|
HCPCS 95911
|
| Min. Negotiated Rate |
$110.94 |
| Max. Negotiated Rate |
$640.30 |
| Rate for Payer: Aetna Commercial |
$244.32
|
| Rate for Payer: Aetna Commercial |
$244.32
|
| Rate for Payer: BCBS Complete |
$177.60
|
| Rate for Payer: BCBS Complete |
$253.60
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$310.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$443.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$110.94
|
| Rate for Payer: Priority Health Narrow Network |
$110.94
|
| Rate for Payer: Priority Health Narrow Network |
$110.94
|
| Rate for Payer: Priority Health SBD |
$282.96
|
| Rate for Payer: Priority Health SBD |
$282.96
|
|
|
PR NERVE GRAFT 1 STRAND ARM/LEG <4 CM
|
Professional
|
Both
|
$2,105.00
|
|
|
Service Code
|
HCPCS 64892
|
| Min. Negotiated Rate |
$214.49 |
| Max. Negotiated Rate |
$1,779.08 |
| Rate for Payer: Aetna Commercial |
$1,351.70
|
| Rate for Payer: BCBS Complete |
$706.95
|
| Rate for Payer: BCBS Trust/PPO |
$214.49
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Mclaren Medicaid |
$673.29
|
| Rate for Payer: Meridian Medicaid |
$706.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,779.08
|
| Rate for Payer: Priority Health Narrow Network |
$1,779.08
|
| Rate for Payer: Priority Health SBD |
$1,779.08
|
|
