|
PR FINGER SPLINT, STATIC
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS Q4049
|
| Min. Negotiated Rate |
$0.88 |
| Max. Negotiated Rate |
$4.96 |
| Rate for Payer: Aetna Commercial |
$3.59
|
| Rate for Payer: Aetna Medicare |
$2.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.86
|
| Rate for Payer: BCBS MAPPO |
$2.68
|
| Rate for Payer: BCN Commercial |
$2.57
|
| Rate for Payer: BCN Medicare Advantage |
$2.68
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cofinity Commercial |
$3.59
|
| Rate for Payer: Cofinity Commercial |
$3.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.68
|
| Rate for Payer: Healthscope Commercial |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$4.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.50
|
| Rate for Payer: Nomi Health Commercial |
$3.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.75
|
| Rate for Payer: PACE SWMI |
$2.68
|
| Rate for Payer: PHP Medicare Advantage |
$2.68
|
| Rate for Payer: Priority Health Medicare |
$2.68
|
| Rate for Payer: Railroad Medicare Medicare |
$2.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.88
|
| Rate for Payer: UHC Core |
$0.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.68
|
| Rate for Payer: UHC Exchange |
$0.88
|
|
|
PR FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED
|
Professional
|
Both
|
$991.00
|
|
|
Service Code
|
HCPCS 46200
|
| Min. Negotiated Rate |
$221.73 |
| Max. Negotiated Rate |
$743.25 |
| Rate for Payer: Aetna Commercial |
$444.81
|
| Rate for Payer: Aetna Medicare |
$345.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$478.01
|
| Rate for Payer: BCBS Complete |
$232.82
|
| Rate for Payer: BCBS MAPPO |
$331.95
|
| Rate for Payer: BCN Commercial |
$515.90
|
| Rate for Payer: BCN Medicare Advantage |
$331.95
|
| Rate for Payer: Cash Price |
$792.80
|
| Rate for Payer: Cash Price |
$792.80
|
| Rate for Payer: Cofinity Commercial |
$478.01
|
| Rate for Payer: Cofinity Commercial |
$444.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$331.95
|
| Rate for Payer: Healthscope Commercial |
$614.11
|
| Rate for Payer: Healthscope Commercial |
$531.12
|
| Rate for Payer: Mclaren Medicaid |
$221.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$348.55
|
| Rate for Payer: Meridian Medicaid |
$232.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$365.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$589.55
|
| Rate for Payer: Nomi Health Commercial |
$398.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$743.25
|
| Rate for Payer: PACE SWMI |
$331.95
|
| Rate for Payer: PHP Medicare Advantage |
$331.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$628.60
|
| Rate for Payer: Priority Health Medicare |
$331.95
|
| Rate for Payer: Priority Health SBD |
$628.60
|
| Rate for Payer: Priority Health Tiered Network |
$628.60
|
| Rate for Payer: Railroad Medicare Medicare |
$331.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$570.58
|
| Rate for Payer: UHC Core |
$570.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$331.95
|
| Rate for Payer: UHC Exchange |
$570.58
|
| Rate for Payer: UHC Medicaid |
$221.73
|
| Rate for Payer: UHCCP Medicaid |
$221.73
|
|
|
PR FIT CONTACT LENS TX OCULAR SURFACE DISEASE
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
HCPCS 92071
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$51.75 |
| Rate for Payer: Aetna Commercial |
$34.36
|
| Rate for Payer: Aetna Medicare |
$26.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.92
|
| Rate for Payer: BCBS Complete |
$17.44
|
| Rate for Payer: BCBS MAPPO |
$25.64
|
| Rate for Payer: BCN Commercial |
$47.31
|
| Rate for Payer: BCN Medicare Advantage |
$25.64
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$36.92
|
| Rate for Payer: Cofinity Commercial |
$34.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.64
|
| Rate for Payer: Healthscope Commercial |
$47.43
|
| Rate for Payer: Healthscope Commercial |
$41.02
|
| Rate for Payer: Mclaren Medicaid |
$16.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.92
|
| Rate for Payer: Meridian Medicaid |
$17.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.92
|
| Rate for Payer: Nomi Health Commercial |
$30.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.75
|
| Rate for Payer: PACE SWMI |
$25.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$40.48
|
| Rate for Payer: Priority Health Medicare |
$25.64
|
| Rate for Payer: Priority Health SBD |
$40.48
|
| Rate for Payer: Priority Health Tiered Network |
$40.48
|
| Rate for Payer: Railroad Medicare Medicare |
$25.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.73
|
| Rate for Payer: UHC Core |
$41.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.64
|
| Rate for Payer: UHC Exchange |
$41.73
|
| Rate for Payer: UHC Medicaid |
$16.61
|
| Rate for Payer: UHCCP Medicaid |
$16.61
|
|
|
PR FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 57160
|
| Min. Negotiated Rate |
$25.77 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$54.28
|
| Rate for Payer: Aetna Medicare |
$42.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.33
|
| Rate for Payer: BCBS Complete |
$27.06
|
| Rate for Payer: BCBS MAPPO |
$40.51
|
| Rate for Payer: BCN Commercial |
$68.72
|
| Rate for Payer: BCN Medicare Advantage |
$40.51
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$58.33
|
| Rate for Payer: Cofinity Commercial |
$54.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.51
|
| Rate for Payer: Healthscope Commercial |
$74.94
|
| Rate for Payer: Healthscope Commercial |
$64.82
|
| Rate for Payer: Mclaren Medicaid |
$25.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.54
|
| Rate for Payer: Meridian Medicaid |
$27.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.37
|
| Rate for Payer: Nomi Health Commercial |
$48.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.00
|
| Rate for Payer: PACE SWMI |
$40.51
|
| Rate for Payer: PHP Medicare Advantage |
$40.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$69.60
|
| Rate for Payer: Priority Health Medicare |
$40.51
|
| Rate for Payer: Priority Health SBD |
$69.60
|
| Rate for Payer: Priority Health Tiered Network |
$69.60
|
| Rate for Payer: Railroad Medicare Medicare |
$40.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.00
|
| Rate for Payer: UHC Core |
$83.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.51
|
| Rate for Payer: UHC Exchange |
$83.00
|
| Rate for Payer: UHC Medicaid |
$25.77
|
| Rate for Payer: UHCCP Medicaid |
$25.77
|
|
|
PR FITTING CONTACT LENS FOR MGMT OF KERATOCONUS 1ST
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 92072
|
| Min. Negotiated Rate |
$48.78 |
| Max. Negotiated Rate |
$171.00 |
| Rate for Payer: Aetna Commercial |
$101.16
|
| Rate for Payer: Aetna Medicare |
$78.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.71
|
| Rate for Payer: BCBS Complete |
$51.22
|
| Rate for Payer: BCBS MAPPO |
$75.49
|
| Rate for Payer: BCN Commercial |
$136.44
|
| Rate for Payer: BCN Medicare Advantage |
$75.49
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$108.71
|
| Rate for Payer: Cofinity Commercial |
$101.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.49
|
| Rate for Payer: Healthscope Commercial |
$139.66
|
| Rate for Payer: Healthscope Commercial |
$120.78
|
| Rate for Payer: Mclaren Medicaid |
$48.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.26
|
| Rate for Payer: Meridian Medicaid |
$51.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.82
|
| Rate for Payer: Nomi Health Commercial |
$90.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.00
|
| Rate for Payer: PACE SWMI |
$75.49
|
| Rate for Payer: PHP Medicare Advantage |
$75.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$116.75
|
| Rate for Payer: Priority Health Medicare |
$75.49
|
| Rate for Payer: Priority Health SBD |
$116.75
|
| Rate for Payer: Priority Health Tiered Network |
$116.75
|
| Rate for Payer: Railroad Medicare Medicare |
$75.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.10
|
| Rate for Payer: UHC Core |
$123.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.49
|
| Rate for Payer: UHC Exchange |
$123.10
|
| Rate for Payer: UHC Medicaid |
$48.78
|
| Rate for Payer: UHCCP Medicaid |
$48.78
|
|
|
PR FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
HCPCS 54620
|
| Min. Negotiated Rate |
$173.81 |
| Max. Negotiated Rate |
$527.41 |
| Rate for Payer: Aetna Commercial |
$359.51
|
| Rate for Payer: Aetna Medicare |
$279.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.34
|
| Rate for Payer: BCBS Complete |
$182.50
|
| Rate for Payer: BCBS MAPPO |
$268.29
|
| Rate for Payer: BCN Commercial |
$447.69
|
| Rate for Payer: BCN Medicare Advantage |
$268.29
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cofinity Commercial |
$386.34
|
| Rate for Payer: Cofinity Commercial |
$359.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.29
|
| Rate for Payer: Healthscope Commercial |
$496.34
|
| Rate for Payer: Healthscope Commercial |
$429.26
|
| Rate for Payer: Mclaren Medicaid |
$173.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.70
|
| Rate for Payer: Meridian Medicaid |
$182.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$295.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$525.38
|
| Rate for Payer: Nomi Health Commercial |
$321.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$443.25
|
| Rate for Payer: PACE SWMI |
$268.29
|
| Rate for Payer: PHP Medicare Advantage |
$268.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$487.68
|
| Rate for Payer: Priority Health Medicare |
$268.29
|
| Rate for Payer: Priority Health SBD |
$487.68
|
| Rate for Payer: Priority Health Tiered Network |
$487.68
|
| Rate for Payer: Railroad Medicare Medicare |
$268.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$527.41
|
| Rate for Payer: UHC Core |
$527.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$268.29
|
| Rate for Payer: UHC Exchange |
$527.41
|
| Rate for Payer: UHC Medicaid |
$173.81
|
| Rate for Payer: UHCCP Medicaid |
$173.81
|
|
|
PR FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY
|
Professional
|
Both
|
$1,785.00
|
|
|
Service Code
|
HCPCS 15740
|
| Min. Negotiated Rate |
$479.04 |
| Max. Negotiated Rate |
$1,474.78 |
| Rate for Payer: Priority Health SBD |
$1,163.15
|
| Rate for Payer: Aetna Commercial |
$981.62
|
| Rate for Payer: Aetna Medicare |
$761.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,054.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$981.62
|
| Rate for Payer: BCBS Complete |
$502.99
|
| Rate for Payer: BCBS MAPPO |
$732.55
|
| Rate for Payer: BCN Commercial |
$1,270.85
|
| Rate for Payer: BCN Medicare Advantage |
$732.55
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cash Price |
$1,428.00
|
| Rate for Payer: Cofinity Commercial |
$981.62
|
| Rate for Payer: Cofinity Commercial |
$1,054.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$732.55
|
| Rate for Payer: Healthscope Commercial |
$1,355.22
|
| Rate for Payer: Healthscope Commercial |
$1,172.08
|
| Rate for Payer: Mclaren Medicaid |
$479.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$769.18
|
| Rate for Payer: Meridian Medicaid |
$502.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$805.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,474.78
|
| Rate for Payer: Nomi Health Commercial |
$879.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,338.75
|
| Rate for Payer: PACE SWMI |
$732.55
|
| Rate for Payer: PHP Medicare Advantage |
$732.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,163.15
|
| Rate for Payer: Priority Health Medicare |
$732.55
|
| Rate for Payer: Priority Health Tiered Network |
$1,163.15
|
| Rate for Payer: Railroad Medicare Medicare |
$732.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,449.49
|
| Rate for Payer: UHC Core |
$1,449.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$732.55
|
| Rate for Payer: UHC Exchange |
$1,449.49
|
| Rate for Payer: UHC Medicaid |
$479.04
|
| Rate for Payer: UHCCP Medicaid |
$479.04
|
|
|
PR FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 92230
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$91.50 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$27.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.02
|
| Rate for Payer: BCBS Complete |
$17.89
|
| Rate for Payer: BCBS MAPPO |
$26.40
|
| Rate for Payer: BCN Commercial |
$46.81
|
| Rate for Payer: BCN Medicare Advantage |
$26.40
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$38.02
|
| Rate for Payer: Cofinity Commercial |
$35.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.40
|
| Rate for Payer: Healthscope Commercial |
$48.84
|
| Rate for Payer: Healthscope Commercial |
$42.24
|
| Rate for Payer: Mclaren Medicaid |
$17.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.72
|
| Rate for Payer: Meridian Medicaid |
$17.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.28
|
| Rate for Payer: Nomi Health Commercial |
$31.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.50
|
| Rate for Payer: PACE SWMI |
$26.40
|
| Rate for Payer: PHP Medicare Advantage |
$26.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$40.06
|
| Rate for Payer: Priority Health Medicare |
$26.40
|
| Rate for Payer: Priority Health SBD |
$40.06
|
| Rate for Payer: Priority Health Tiered Network |
$40.06
|
| Rate for Payer: Railroad Medicare Medicare |
$26.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.14
|
| Rate for Payer: UHC Core |
$42.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.40
|
| Rate for Payer: UHC Exchange |
$42.14
|
| Rate for Payer: UHC Medicaid |
$17.04
|
| Rate for Payer: UHCCP Medicaid |
$17.04
|
|
|
PR FLUPHENAZINE DECANOATE 25 MG
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS J2680
|
| Min. Negotiated Rate |
$4.04 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Aetna Commercial |
$7.49
|
| Rate for Payer: Aetna Medicare |
$5.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.05
|
| Rate for Payer: BCBS MAPPO |
$5.59
|
| Rate for Payer: BCBS Trust/PPO |
$4.04
|
| Rate for Payer: BCN Commercial |
$5.66
|
| Rate for Payer: BCN Medicare Advantage |
$5.59
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$7.49
|
| Rate for Payer: Cofinity Commercial |
$8.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.59
|
| Rate for Payer: Healthscope Commercial |
$10.34
|
| Rate for Payer: Healthscope Commercial |
$8.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.87
|
| Rate for Payer: Nomi Health Commercial |
$6.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: PACE SWMI |
$5.59
|
| Rate for Payer: PHP Medicare Advantage |
$5.59
|
| Rate for Payer: Priority Health Medicare |
$5.59
|
| Rate for Payer: Railroad Medicare Medicare |
$5.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.20
|
| Rate for Payer: UHC Core |
$6.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.59
|
| Rate for Payer: UHC Exchange |
$6.20
|
|
|
PR FLUVIRIN VACC, 3 YRS & >, IM
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS Q2037
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$18.62 |
| Rate for Payer: Aetna Commercial |
$18.62
|
| Rate for Payer: Aetna Medicare |
$10.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.62
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.62
|
| Rate for Payer: UHC Core |
$18.62
|
| Rate for Payer: UHC Exchange |
$18.62
|
|
|
PR FLUZONE VACC, 3 YRS & >, IM
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS Q2038
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$55.94 |
| Rate for Payer: Aetna Commercial |
$12.68
|
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.68
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.94
|
| Rate for Payer: UHC Core |
$55.94
|
| Rate for Payer: UHC Exchange |
$55.94
|
|
|
PR FOLLOWUP EVAL OF FOOT PT LOP
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS G0246
|
| Min. Negotiated Rate |
$17.28 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: Aetna Commercial |
$23.16
|
| Rate for Payer: Aetna Medicare |
$17.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.88
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: BCBS MAPPO |
$17.28
|
| Rate for Payer: BCN Commercial |
$29.38
|
| Rate for Payer: BCN Medicare Advantage |
$17.28
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$24.88
|
| Rate for Payer: Cofinity Commercial |
$23.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.28
|
| Rate for Payer: Healthscope Commercial |
$31.97
|
| Rate for Payer: Healthscope Commercial |
$27.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.52
|
| Rate for Payer: Nomi Health Commercial |
$20.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.00
|
| Rate for Payer: PACE SWMI |
$17.28
|
| Rate for Payer: PHP Medicare Advantage |
$17.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22.37
|
| Rate for Payer: Priority Health Medicare |
$17.28
|
| Rate for Payer: Priority Health SBD |
$22.37
|
| Rate for Payer: Priority Health Tiered Network |
$22.37
|
| Rate for Payer: Railroad Medicare Medicare |
$17.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.71
|
| Rate for Payer: UHC Core |
$29.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.28
|
| Rate for Payer: UHC Exchange |
$29.71
|
|
|
PR FOLLOW-UP/REASSESSMENT
|
Professional
|
Both
|
$315.00
|
|
|
Service Code
|
HCPCS S0316
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: Aetna Commercial |
$20.00
|
| Rate for Payer: Aetna Medicare |
$157.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.00
|
| Rate for Payer: BCBS Complete |
$126.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
|
|
PR FO NONTORSION JOINT CF
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS L3935
|
| Min. Negotiated Rate |
$80.57 |
| Max. Negotiated Rate |
$457.08 |
| Rate for Payer: Aetna Commercial |
$331.07
|
| Rate for Payer: Aetna Medicare |
$256.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.78
|
| Rate for Payer: BCBS Complete |
$85.20
|
| Rate for Payer: BCBS MAPPO |
$247.07
|
| Rate for Payer: BCN Commercial |
$236.55
|
| Rate for Payer: BCN Medicare Advantage |
$247.07
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$331.07
|
| Rate for Payer: Cofinity Commercial |
$355.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.07
|
| Rate for Payer: Healthscope Commercial |
$457.08
|
| Rate for Payer: Healthscope Commercial |
$395.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$271.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$230.56
|
| Rate for Payer: Nomi Health Commercial |
$296.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.75
|
| Rate for Payer: PACE SWMI |
$247.07
|
| Rate for Payer: PHP Medicare Advantage |
$247.07
|
| Rate for Payer: Priority Health Medicare |
$247.07
|
| Rate for Payer: Railroad Medicare Medicare |
$247.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.57
|
| Rate for Payer: UHC Core |
$80.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$247.07
|
| Rate for Payer: UHC Exchange |
$80.57
|
|
|
PR FOOT ARCH SUPP LONGITUD/META
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS L3060
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$167.70 |
| Rate for Payer: Aetna Commercial |
$121.47
|
| Rate for Payer: Aetna Medicare |
$94.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.54
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCBS MAPPO |
$90.65
|
| Rate for Payer: BCN Commercial |
$86.79
|
| Rate for Payer: BCN Medicare Advantage |
$90.65
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$130.54
|
| Rate for Payer: Cofinity Commercial |
$121.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.65
|
| Rate for Payer: Healthscope Commercial |
$145.04
|
| Rate for Payer: Healthscope Commercial |
$167.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$99.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.59
|
| Rate for Payer: Nomi Health Commercial |
$108.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.50
|
| Rate for Payer: PACE SWMI |
$90.65
|
| Rate for Payer: PHP Medicare Advantage |
$90.65
|
| Rate for Payer: Priority Health Medicare |
$90.65
|
| Rate for Payer: Railroad Medicare Medicare |
$90.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.56
|
| Rate for Payer: UHC Core |
$29.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$90.65
|
| Rate for Payer: UHC Exchange |
$29.56
|
|
|
PR FOOT PLAS HEEL STABI PRE OTS
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS L3170
|
| Min. Negotiated Rate |
$20.38 |
| Max. Negotiated Rate |
$115.66 |
| Rate for Payer: Aetna Commercial |
$83.78
|
| Rate for Payer: Aetna Medicare |
$65.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.03
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: BCBS MAPPO |
$62.52
|
| Rate for Payer: BCN Commercial |
$59.85
|
| Rate for Payer: BCN Medicare Advantage |
$62.52
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$90.03
|
| Rate for Payer: Cofinity Commercial |
$83.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.52
|
| Rate for Payer: Healthscope Commercial |
$100.03
|
| Rate for Payer: Healthscope Commercial |
$115.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.33
|
| Rate for Payer: Nomi Health Commercial |
$75.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PACE SWMI |
$62.52
|
| Rate for Payer: PHP Medicare Advantage |
$62.52
|
| Rate for Payer: Priority Health Medicare |
$62.52
|
| Rate for Payer: Railroad Medicare Medicare |
$62.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.38
|
| Rate for Payer: UHC Core |
$20.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.52
|
| Rate for Payer: UHC Exchange |
$20.38
|
|
|
PR FO PIP DIP JNT/SPRNG PRE OTS
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS L3925
|
| Min. Negotiated Rate |
$23.96 |
| Max. Negotiated Rate |
$135.92 |
| Rate for Payer: Aetna Commercial |
$98.45
|
| Rate for Payer: Aetna Medicare |
$76.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.45
|
| Rate for Payer: BCBS Complete |
$25.60
|
| Rate for Payer: BCBS MAPPO |
$73.47
|
| Rate for Payer: BCN Commercial |
$70.34
|
| Rate for Payer: BCN Medicare Advantage |
$73.47
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$98.45
|
| Rate for Payer: Cofinity Commercial |
$105.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.47
|
| Rate for Payer: Healthscope Commercial |
$117.55
|
| Rate for Payer: Healthscope Commercial |
$135.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.56
|
| Rate for Payer: Nomi Health Commercial |
$88.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.00
|
| Rate for Payer: PACE SWMI |
$73.47
|
| Rate for Payer: PHP Medicare Advantage |
$73.47
|
| Rate for Payer: Priority Health Medicare |
$73.47
|
| Rate for Payer: Railroad Medicare Medicare |
$73.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.96
|
| Rate for Payer: UHC Core |
$23.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$73.47
|
| Rate for Payer: UHC Exchange |
$23.96
|
|
|
PR FOREARM/ARM CUFFS FREE MOTIO
|
Professional
|
Both
|
$657.00
|
|
|
Service Code
|
HCPCS L3720
|
| Min. Negotiated Rate |
$249.19 |
| Max. Negotiated Rate |
$1,413.81 |
| Rate for Payer: Aetna Commercial |
$1,024.05
|
| Rate for Payer: Aetna Medicare |
$794.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,024.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,100.48
|
| Rate for Payer: BCBS Complete |
$262.80
|
| Rate for Payer: BCBS MAPPO |
$764.22
|
| Rate for Payer: BCN Commercial |
$731.68
|
| Rate for Payer: BCN Medicare Advantage |
$764.22
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cash Price |
$525.60
|
| Rate for Payer: Cofinity Commercial |
$1,100.48
|
| Rate for Payer: Cofinity Commercial |
$1,024.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$764.22
|
| Rate for Payer: Healthscope Commercial |
$1,222.75
|
| Rate for Payer: Healthscope Commercial |
$1,413.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$802.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$840.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$713.14
|
| Rate for Payer: Nomi Health Commercial |
$917.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$492.75
|
| Rate for Payer: PACE SWMI |
$764.22
|
| Rate for Payer: PHP Medicare Advantage |
$764.22
|
| Rate for Payer: Priority Health Medicare |
$764.22
|
| Rate for Payer: Railroad Medicare Medicare |
$764.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.19
|
| Rate for Payer: UHC Core |
$249.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$764.22
|
| Rate for Payer: UHC Exchange |
$249.19
|
|
|
PR FOREHEAD FLAP W/PRESERVATION VASCULAR PEDICLE
|
Professional
|
Both
|
$2,327.00
|
|
|
Service Code
|
HCPCS 15731
|
| Min. Negotiated Rate |
$559.55 |
| Max. Negotiated Rate |
$1,753.78 |
| Rate for Payer: Aetna Commercial |
$1,148.76
|
| Rate for Payer: Aetna Medicare |
$891.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,148.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,234.48
|
| Rate for Payer: BCBS Complete |
$587.53
|
| Rate for Payer: BCBS MAPPO |
$857.28
|
| Rate for Payer: BCN Commercial |
$1,498.42
|
| Rate for Payer: BCN Medicare Advantage |
$857.28
|
| Rate for Payer: Cash Price |
$1,861.60
|
| Rate for Payer: Cash Price |
$1,861.60
|
| Rate for Payer: Cofinity Commercial |
$1,234.48
|
| Rate for Payer: Cofinity Commercial |
$1,148.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$857.28
|
| Rate for Payer: Healthscope Commercial |
$1,585.97
|
| Rate for Payer: Healthscope Commercial |
$1,371.65
|
| Rate for Payer: Mclaren Medicaid |
$559.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$900.14
|
| Rate for Payer: Meridian Medicaid |
$587.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$943.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,753.78
|
| Rate for Payer: Nomi Health Commercial |
$1,028.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,745.25
|
| Rate for Payer: PACE SWMI |
$857.28
|
| Rate for Payer: PHP Medicare Advantage |
$857.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$559.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,371.45
|
| Rate for Payer: Priority Health Medicare |
$857.28
|
| Rate for Payer: Priority Health SBD |
$1,371.45
|
| Rate for Payer: Priority Health Tiered Network |
$1,371.45
|
| Rate for Payer: Railroad Medicare Medicare |
$857.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,735.06
|
| Rate for Payer: UHC Core |
$1,735.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$857.28
|
| Rate for Payer: UHC Exchange |
$1,735.06
|
| Rate for Payer: UHC Medicaid |
$559.55
|
| Rate for Payer: UHCCP Medicaid |
$559.55
|
|
|
PR FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 54450
|
| Min. Negotiated Rate |
$32.16 |
| Max. Negotiated Rate |
$118.50 |
| Rate for Payer: Aetna Commercial |
$67.40
|
| Rate for Payer: Aetna Medicare |
$52.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.43
|
| Rate for Payer: BCBS Complete |
$33.77
|
| Rate for Payer: BCBS MAPPO |
$50.30
|
| Rate for Payer: BCN Commercial |
$85.15
|
| Rate for Payer: BCN Medicare Advantage |
$50.30
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$72.43
|
| Rate for Payer: Cofinity Commercial |
$67.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.30
|
| Rate for Payer: Healthscope Commercial |
$93.06
|
| Rate for Payer: Healthscope Commercial |
$80.48
|
| Rate for Payer: Mclaren Medicaid |
$32.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.81
|
| Rate for Payer: Meridian Medicaid |
$33.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.84
|
| Rate for Payer: Nomi Health Commercial |
$60.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
| Rate for Payer: PACE SWMI |
$50.30
|
| Rate for Payer: PHP Medicare Advantage |
$50.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$92.76
|
| Rate for Payer: Priority Health Medicare |
$50.30
|
| Rate for Payer: Priority Health SBD |
$92.76
|
| Rate for Payer: Priority Health Tiered Network |
$92.76
|
| Rate for Payer: Railroad Medicare Medicare |
$50.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.05
|
| Rate for Payer: UHC Core |
$102.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$50.30
|
| Rate for Payer: UHC Exchange |
$102.05
|
| Rate for Payer: UHC Medicaid |
$32.16
|
| Rate for Payer: UHCCP Medicaid |
$32.16
|
|
|
PR FO W/O JOINTS CF
|
Professional
|
Both
|
$206.00
|
|
|
Service Code
|
HCPCS L3933
|
| Min. Negotiated Rate |
$77.82 |
| Max. Negotiated Rate |
$441.48 |
| Rate for Payer: Aetna Commercial |
$319.78
|
| Rate for Payer: Aetna Medicare |
$248.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$319.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$343.64
|
| Rate for Payer: BCBS Complete |
$82.40
|
| Rate for Payer: BCBS MAPPO |
$238.64
|
| Rate for Payer: BCN Commercial |
$228.48
|
| Rate for Payer: BCN Medicare Advantage |
$238.64
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$343.64
|
| Rate for Payer: Cofinity Commercial |
$319.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.64
|
| Rate for Payer: Healthscope Commercial |
$441.48
|
| Rate for Payer: Healthscope Commercial |
$381.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$262.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.69
|
| Rate for Payer: Nomi Health Commercial |
$286.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$154.50
|
| Rate for Payer: PACE SWMI |
$238.64
|
| Rate for Payer: PHP Medicare Advantage |
$238.64
|
| Rate for Payer: Priority Health Medicare |
$238.64
|
| Rate for Payer: Railroad Medicare Medicare |
$238.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.82
|
| Rate for Payer: UHC Core |
$77.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$238.64
|
| Rate for Payer: UHC Exchange |
$77.82
|
|
|
PR FRAC FL FACE
|
Professional
|
Both
|
$420.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$168.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna Medicare |
$210.00
|
| Rate for Payer: BCBS Complete |
$168.00
|
| Rate for Payer: Cash Price |
$336.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$315.00
|
|
|
PR FRAC NECK
|
Professional
|
Both
|
$158.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$63.20 |
| Max. Negotiated Rate |
$118.50 |
| Rate for Payer: Aetna Medicare |
$79.00
|
| Rate for Payer: BCBS Complete |
$63.20
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
|
|
PR FRAC SCARS PER INCH
|
Professional
|
Both
|
$53.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
|
|
PR FRAC THGH/ABD/BACK
|
Professional
|
Both
|
$473.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$189.20 |
| Max. Negotiated Rate |
$354.75 |
| Rate for Payer: Aetna Medicare |
$236.50
|
| Rate for Payer: BCBS Complete |
$189.20
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$307.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.75
|
|
