|
PR NJX AA&/STRD PLANTAR COMMON DIGITAL NERVES
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 64455
|
| Min. Negotiated Rate |
$19.17 |
| Max. Negotiated Rate |
$245.25 |
| Rate for Payer: Aetna Commercial |
$40.29
|
| Rate for Payer: Aetna Medicare |
$31.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.30
|
| Rate for Payer: BCBS Complete |
$20.13
|
| Rate for Payer: BCBS MAPPO |
$30.07
|
| Rate for Payer: BCN Commercial |
$49.30
|
| Rate for Payer: BCN Medicare Advantage |
$30.07
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$43.30
|
| Rate for Payer: Cofinity Commercial |
$40.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.07
|
| Rate for Payer: Healthscope Commercial |
$55.63
|
| Rate for Payer: Healthscope Commercial |
$48.11
|
| Rate for Payer: Mclaren Medicaid |
$19.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.57
|
| Rate for Payer: Meridian Medicaid |
$20.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.69
|
| Rate for Payer: Nomi Health Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.25
|
| Rate for Payer: PACE SWMI |
$30.07
|
| Rate for Payer: PHP Medicare Advantage |
$30.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$57.26
|
| Rate for Payer: Priority Health Medicare |
$30.07
|
| Rate for Payer: Priority Health SBD |
$57.26
|
| Rate for Payer: Priority Health Tiered Network |
$57.26
|
| Rate for Payer: Railroad Medicare Medicare |
$30.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.77
|
| Rate for Payer: UHC Core |
$61.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.07
|
| Rate for Payer: UHC Exchange |
$61.77
|
| Rate for Payer: UHC Medicaid |
$19.17
|
| Rate for Payer: UHCCP Medicaid |
$19.17
|
|
|
PR NJX AA&/STRD TFRML EPI CERVICAL/THORACIC 1 LEVEL
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 64479
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$245.25 |
| Rate for Payer: Aetna Commercial |
$153.23
|
| Rate for Payer: Aetna Commercial |
$153.23
|
| Rate for Payer: Aetna Medicare |
$118.92
|
| Rate for Payer: Aetna Medicare |
$118.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.23
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS MAPPO |
$114.35
|
| Rate for Payer: BCBS MAPPO |
$114.35
|
| Rate for Payer: BCN Commercial |
$195.21
|
| Rate for Payer: BCN Commercial |
$195.21
|
| Rate for Payer: BCN Medicare Advantage |
$114.35
|
| Rate for Payer: BCN Medicare Advantage |
$114.35
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cofinity Commercial |
$164.66
|
| Rate for Payer: Cofinity Commercial |
$153.23
|
| Rate for Payer: Cofinity Commercial |
$153.23
|
| Rate for Payer: Cofinity Commercial |
$164.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.35
|
| Rate for Payer: Healthscope Commercial |
$211.55
|
| Rate for Payer: Healthscope Commercial |
$182.96
|
| Rate for Payer: Healthscope Commercial |
$182.96
|
| Rate for Payer: Healthscope Commercial |
$211.55
|
| Rate for Payer: Mclaren Medicaid |
$74.34
|
| Rate for Payer: Mclaren Medicaid |
$74.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.07
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$125.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$125.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.58
|
| Rate for Payer: Nomi Health Commercial |
$137.22
|
| Rate for Payer: Nomi Health Commercial |
$137.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$690.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.25
|
| Rate for Payer: PACE SWMI |
$114.35
|
| Rate for Payer: PACE SWMI |
$114.35
|
| Rate for Payer: PHP Medicare Advantage |
$114.35
|
| Rate for Payer: PHP Medicare Advantage |
$114.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$226.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$226.73
|
| Rate for Payer: Priority Health Medicare |
$114.35
|
| Rate for Payer: Priority Health Medicare |
$114.35
|
| Rate for Payer: Priority Health SBD |
$226.73
|
| Rate for Payer: Priority Health SBD |
$226.73
|
| Rate for Payer: Priority Health Tiered Network |
$226.73
|
| Rate for Payer: Priority Health Tiered Network |
$226.73
|
| Rate for Payer: Railroad Medicare Medicare |
$114.35
|
| Rate for Payer: Railroad Medicare Medicare |
$114.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.99
|
| Rate for Payer: UHC Core |
$229.99
|
| Rate for Payer: UHC Core |
$229.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$114.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$114.35
|
| Rate for Payer: UHC Exchange |
$229.99
|
| Rate for Payer: UHC Exchange |
$229.99
|
| Rate for Payer: UHC Medicaid |
$74.34
|
| Rate for Payer: UHC Medicaid |
$74.34
|
| Rate for Payer: UHCCP Medicaid |
$74.34
|
| Rate for Payer: UHCCP Medicaid |
$74.34
|
|
|
PR NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL
|
Professional
|
Both
|
$356.00
|
|
|
Service Code
|
HCPCS 64480
|
| Min. Negotiated Rate |
$33.87 |
| Max. Negotiated Rate |
$267.00 |
| Rate for Payer: Aetna Commercial |
$70.59
|
| Rate for Payer: Aetna Medicare |
$54.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.86
|
| Rate for Payer: BCBS Complete |
$35.56
|
| Rate for Payer: BCBS MAPPO |
$52.68
|
| Rate for Payer: BCN Commercial |
$91.63
|
| Rate for Payer: BCN Medicare Advantage |
$52.68
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Cofinity Commercial |
$75.86
|
| Rate for Payer: Cofinity Commercial |
$70.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.68
|
| Rate for Payer: Healthscope Commercial |
$97.46
|
| Rate for Payer: Healthscope Commercial |
$84.29
|
| Rate for Payer: Mclaren Medicaid |
$33.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.31
|
| Rate for Payer: Meridian Medicaid |
$35.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.31
|
| Rate for Payer: Nomi Health Commercial |
$63.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.00
|
| Rate for Payer: PACE SWMI |
$52.68
|
| Rate for Payer: PHP Medicare Advantage |
$52.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$106.43
|
| Rate for Payer: Priority Health Medicare |
$52.68
|
| Rate for Payer: Priority Health SBD |
$106.43
|
| Rate for Payer: Priority Health Tiered Network |
$106.43
|
| Rate for Payer: Railroad Medicare Medicare |
$52.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.46
|
| Rate for Payer: UHC Core |
$110.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.68
|
| Rate for Payer: UHC Exchange |
$110.46
|
| Rate for Payer: UHC Medicaid |
$33.87
|
| Rate for Payer: UHCCP Medicaid |
$33.87
|
|
|
PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL
|
Professional
|
Both
|
$1,051.00
|
|
|
Service Code
|
HCPCS 64483
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$788.25 |
| Rate for Payer: Aetna Commercial |
$130.62
|
| Rate for Payer: Aetna Commercial |
$130.62
|
| Rate for Payer: Aetna Medicare |
$101.38
|
| Rate for Payer: Aetna Medicare |
$101.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.62
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$97.48
|
| Rate for Payer: BCBS MAPPO |
$97.48
|
| Rate for Payer: BCN Commercial |
$165.83
|
| Rate for Payer: BCN Commercial |
$165.83
|
| Rate for Payer: BCN Medicare Advantage |
$97.48
|
| Rate for Payer: BCN Medicare Advantage |
$97.48
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$840.80
|
| Rate for Payer: Cash Price |
$840.80
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$140.37
|
| Rate for Payer: Cofinity Commercial |
$130.62
|
| Rate for Payer: Cofinity Commercial |
$130.62
|
| Rate for Payer: Cofinity Commercial |
$140.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.48
|
| Rate for Payer: Healthscope Commercial |
$180.34
|
| Rate for Payer: Healthscope Commercial |
$155.97
|
| Rate for Payer: Healthscope Commercial |
$155.97
|
| Rate for Payer: Healthscope Commercial |
$180.34
|
| Rate for Payer: Mclaren Medicaid |
$63.47
|
| Rate for Payer: Mclaren Medicaid |
$63.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.35
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.84
|
| Rate for Payer: Nomi Health Commercial |
$116.98
|
| Rate for Payer: Nomi Health Commercial |
$116.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$788.25
|
| Rate for Payer: PACE SWMI |
$97.48
|
| Rate for Payer: PACE SWMI |
$97.48
|
| Rate for Payer: PHP Medicare Advantage |
$97.48
|
| Rate for Payer: PHP Medicare Advantage |
$97.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$192.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$192.60
|
| Rate for Payer: Priority Health Medicare |
$97.48
|
| Rate for Payer: Priority Health Medicare |
$97.48
|
| Rate for Payer: Priority Health SBD |
$192.60
|
| Rate for Payer: Priority Health SBD |
$192.60
|
| Rate for Payer: Priority Health Tiered Network |
$192.60
|
| Rate for Payer: Priority Health Tiered Network |
$192.60
|
| Rate for Payer: Railroad Medicare Medicare |
$97.48
|
| Rate for Payer: Railroad Medicare Medicare |
$97.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.52
|
| Rate for Payer: UHC Core |
$195.52
|
| Rate for Payer: UHC Core |
$195.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.48
|
| Rate for Payer: UHC Exchange |
$195.52
|
| Rate for Payer: UHC Exchange |
$195.52
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL
|
Professional
|
Both
|
$458.00
|
|
|
Service Code
|
HCPCS 64484
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$343.50 |
| Rate for Payer: Aetna Commercial |
$58.12
|
| Rate for Payer: Aetna Medicare |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.45
|
| Rate for Payer: BCBS Complete |
$29.30
|
| Rate for Payer: BCBS MAPPO |
$43.37
|
| Rate for Payer: BCN Commercial |
$75.19
|
| Rate for Payer: BCN Medicare Advantage |
$43.37
|
| Rate for Payer: Cash Price |
$366.40
|
| Rate for Payer: Cash Price |
$366.40
|
| Rate for Payer: Cofinity Commercial |
$62.45
|
| Rate for Payer: Cofinity Commercial |
$58.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.37
|
| Rate for Payer: Healthscope Commercial |
$80.23
|
| Rate for Payer: Healthscope Commercial |
$69.39
|
| Rate for Payer: Mclaren Medicaid |
$27.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.54
|
| Rate for Payer: Meridian Medicaid |
$29.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.90
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$343.50
|
| Rate for Payer: PACE SWMI |
$43.37
|
| Rate for Payer: PHP Medicare Advantage |
$43.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$87.33
|
| Rate for Payer: Priority Health Medicare |
$43.37
|
| Rate for Payer: Priority Health SBD |
$87.33
|
| Rate for Payer: Priority Health Tiered Network |
$87.33
|
| Rate for Payer: Railroad Medicare Medicare |
$43.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.99
|
| Rate for Payer: UHC Core |
$91.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.37
|
| Rate for Payer: UHC Exchange |
$91.99
|
| Rate for Payer: UHC Medicaid |
$27.90
|
| Rate for Payer: UHCCP Medicaid |
$27.90
|
|
|
PR NJX BONE SUB MATRL INTO SUBCHONDRAL BONE DEFECT
|
Professional
|
Both
|
$3,152.00
|
|
|
Service Code
|
HCPCS 0707T
|
| Min. Negotiated Rate |
$368.07 |
| Max. Negotiated Rate |
$3,033.71 |
| Rate for Payer: Aetna Commercial |
$368.07
|
| Rate for Payer: Aetna Medicare |
$1,576.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$368.07
|
| Rate for Payer: BCBS Complete |
$1,260.80
|
| Rate for Payer: BCN Commercial |
$3,033.71
|
| Rate for Payer: Cash Price |
$2,521.60
|
| Rate for Payer: Cash Price |
$2,521.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$623.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,364.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$638.56
|
| Rate for Payer: UHC Core |
$638.56
|
| Rate for Payer: UHC Exchange |
$638.56
|
|
|
PR NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY
|
Professional
|
Both
|
$710.00
|
|
|
Service Code
|
HCPCS 51600
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$532.50 |
| Rate for Payer: Aetna Commercial |
$49.98
|
| Rate for Payer: Aetna Medicare |
$38.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.71
|
| Rate for Payer: BCBS Complete |
$25.05
|
| Rate for Payer: BCBS MAPPO |
$37.30
|
| Rate for Payer: BCN Commercial |
$63.74
|
| Rate for Payer: BCN Medicare Advantage |
$37.30
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cofinity Commercial |
$53.71
|
| Rate for Payer: Cofinity Commercial |
$49.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.30
|
| Rate for Payer: Healthscope Commercial |
$59.68
|
| Rate for Payer: Healthscope Commercial |
$69.00
|
| Rate for Payer: Mclaren Medicaid |
$23.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.16
|
| Rate for Payer: Meridian Medicaid |
$25.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.47
|
| Rate for Payer: Nomi Health Commercial |
$44.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$532.50
|
| Rate for Payer: PACE SWMI |
$37.30
|
| Rate for Payer: PHP Medicare Advantage |
$37.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$69.43
|
| Rate for Payer: Priority Health Medicare |
$37.30
|
| Rate for Payer: Priority Health SBD |
$69.43
|
| Rate for Payer: Priority Health Tiered Network |
$69.43
|
| Rate for Payer: Railroad Medicare Medicare |
$37.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.72
|
| Rate for Payer: UHC Core |
$78.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.30
|
| Rate for Payer: UHC Exchange |
$78.72
|
| Rate for Payer: UHC Medicaid |
$23.86
|
| Rate for Payer: UHCCP Medicaid |
$23.86
|
|
|
PR NJX DRG C-CATHJ SLCTV L VNTRC/L ATRIAL ANGRPHS&I
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 93565
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$73.46 |
| Rate for Payer: Aetna Commercial |
$31.68
|
| Rate for Payer: Aetna Medicare |
$24.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.04
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCBS MAPPO |
$23.64
|
| Rate for Payer: BCN Commercial |
$39.84
|
| Rate for Payer: BCN Medicare Advantage |
$23.64
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$34.04
|
| Rate for Payer: Cofinity Commercial |
$31.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.64
|
| Rate for Payer: Healthscope Commercial |
$43.73
|
| Rate for Payer: Healthscope Commercial |
$37.82
|
| Rate for Payer: Mclaren Medicaid |
$14.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.82
|
| Rate for Payer: Meridian Medicaid |
$15.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.86
|
| Rate for Payer: Nomi Health Commercial |
$28.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.75
|
| Rate for Payer: PACE SWMI |
$23.64
|
| Rate for Payer: PHP Medicare Advantage |
$23.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37.87
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health SBD |
$37.87
|
| Rate for Payer: Priority Health Tiered Network |
$37.87
|
| Rate for Payer: Railroad Medicare Medicare |
$23.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.46
|
| Rate for Payer: UHC Core |
$73.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.64
|
| Rate for Payer: UHC Exchange |
$73.46
|
| Rate for Payer: UHC Medicaid |
$14.91
|
| Rate for Payer: UHCCP Medicaid |
$14.91
|
|
|
PR NJX DRG C-CATHJ SLCTV R VNTRC/R ATRIAL ANGRPHS&I
|
Professional
|
Both
|
$297.00
|
|
|
Service Code
|
HCPCS 93566
|
| Min. Negotiated Rate |
$14.27 |
| Max. Negotiated Rate |
$222.75 |
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna Medicare |
$23.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.30
|
| Rate for Payer: BCBS Complete |
$14.98
|
| Rate for Payer: BCBS MAPPO |
$22.43
|
| Rate for Payer: BCN Commercial |
$37.85
|
| Rate for Payer: BCN Medicare Advantage |
$22.43
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cofinity Commercial |
$32.30
|
| Rate for Payer: Cofinity Commercial |
$30.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.43
|
| Rate for Payer: Healthscope Commercial |
$41.50
|
| Rate for Payer: Healthscope Commercial |
$35.89
|
| Rate for Payer: Mclaren Medicaid |
$14.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.55
|
| Rate for Payer: Meridian Medicaid |
$14.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.23
|
| Rate for Payer: Nomi Health Commercial |
$26.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.75
|
| Rate for Payer: PACE SWMI |
$22.43
|
| Rate for Payer: PHP Medicare Advantage |
$22.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.97
|
| Rate for Payer: Priority Health Medicare |
$22.43
|
| Rate for Payer: Priority Health SBD |
$35.97
|
| Rate for Payer: Priority Health Tiered Network |
$35.97
|
| Rate for Payer: Railroad Medicare Medicare |
$22.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.36
|
| Rate for Payer: UHC Core |
$76.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.43
|
| Rate for Payer: UHC Exchange |
$76.36
|
| Rate for Payer: UHC Medicaid |
$14.27
|
| Rate for Payer: UHCCP Medicaid |
$14.27
|
|
|
PR NJX DRG C-CATHJ SUPRAVALVULAR AORTOGRAPHY S&I
|
Professional
|
Both
|
$440.00
|
|
|
Service Code
|
HCPCS 93567
|
| Min. Negotiated Rate |
$20.66 |
| Max. Negotiated Rate |
$330.00 |
| Rate for Payer: Aetna Commercial |
$43.83
|
| Rate for Payer: Aetna Medicare |
$34.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.10
|
| Rate for Payer: BCBS Complete |
$21.69
|
| Rate for Payer: BCBS MAPPO |
$32.71
|
| Rate for Payer: BCN Commercial |
$54.78
|
| Rate for Payer: BCN Medicare Advantage |
$32.71
|
| Rate for Payer: Cash Price |
$352.00
|
| Rate for Payer: Cash Price |
$352.00
|
| Rate for Payer: Cofinity Commercial |
$47.10
|
| Rate for Payer: Cofinity Commercial |
$43.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.71
|
| Rate for Payer: Healthscope Commercial |
$60.51
|
| Rate for Payer: Healthscope Commercial |
$52.34
|
| Rate for Payer: Mclaren Medicaid |
$20.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.35
|
| Rate for Payer: Meridian Medicaid |
$21.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.00
|
| Rate for Payer: Nomi Health Commercial |
$39.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$330.00
|
| Rate for Payer: PACE SWMI |
$32.71
|
| Rate for Payer: PHP Medicare Advantage |
$32.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$52.06
|
| Rate for Payer: Priority Health Medicare |
$32.71
|
| Rate for Payer: Priority Health SBD |
$52.06
|
| Rate for Payer: Priority Health Tiered Network |
$52.06
|
| Rate for Payer: Railroad Medicare Medicare |
$32.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.21
|
| Rate for Payer: UHC Core |
$87.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.71
|
| Rate for Payer: UHC Exchange |
$87.21
|
| Rate for Payer: UHC Medicaid |
$20.66
|
| Rate for Payer: UHCCP Medicaid |
$20.66
|
|
|
PR NJX DRG CGEN C-CATHJ SLCTV CORONARY ANGRPH S&I
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 93563
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$95.15 |
| Rate for Payer: Aetna Commercial |
$59.71
|
| Rate for Payer: Aetna Medicare |
$46.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.17
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS MAPPO |
$44.56
|
| Rate for Payer: BCN Commercial |
$75.19
|
| Rate for Payer: BCN Medicare Advantage |
$44.56
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$64.17
|
| Rate for Payer: Cofinity Commercial |
$59.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.56
|
| Rate for Payer: Healthscope Commercial |
$82.44
|
| Rate for Payer: Healthscope Commercial |
$71.30
|
| Rate for Payer: Mclaren Medicaid |
$28.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.79
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.34
|
| Rate for Payer: Nomi Health Commercial |
$53.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.50
|
| Rate for Payer: PACE SWMI |
$44.56
|
| Rate for Payer: PHP Medicare Advantage |
$44.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71.46
|
| Rate for Payer: Priority Health Medicare |
$44.56
|
| Rate for Payer: Priority Health SBD |
$71.46
|
| Rate for Payer: Priority Health Tiered Network |
$71.46
|
| Rate for Payer: Railroad Medicare Medicare |
$44.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.15
|
| Rate for Payer: UHC Core |
$95.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.56
|
| Rate for Payer: UHC Exchange |
$95.15
|
| Rate for Payer: UHC Medicaid |
$28.33
|
| Rate for Payer: UHCCP Medicaid |
$28.33
|
|
|
PR NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL
|
Professional
|
Both
|
$349.00
|
|
|
Service Code
|
HCPCS 64490
|
| Min. Negotiated Rate |
$60.07 |
| Max. Negotiated Rate |
$261.75 |
| Rate for Payer: Aetna Commercial |
$123.78
|
| Rate for Payer: Aetna Medicare |
$96.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.01
|
| Rate for Payer: BCBS Complete |
$63.07
|
| Rate for Payer: BCBS MAPPO |
$92.37
|
| Rate for Payer: BCN Commercial |
$157.36
|
| Rate for Payer: BCN Medicare Advantage |
$92.37
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cofinity Commercial |
$133.01
|
| Rate for Payer: Cofinity Commercial |
$123.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.37
|
| Rate for Payer: Healthscope Commercial |
$170.88
|
| Rate for Payer: Healthscope Commercial |
$147.79
|
| Rate for Payer: Mclaren Medicaid |
$60.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.99
|
| Rate for Payer: Meridian Medicaid |
$63.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$101.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.96
|
| Rate for Payer: Nomi Health Commercial |
$110.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.75
|
| Rate for Payer: PACE SWMI |
$92.37
|
| Rate for Payer: PHP Medicare Advantage |
$92.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$182.76
|
| Rate for Payer: Priority Health Medicare |
$92.37
|
| Rate for Payer: Priority Health SBD |
$182.76
|
| Rate for Payer: Priority Health Tiered Network |
$182.76
|
| Rate for Payer: Railroad Medicare Medicare |
$92.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.34
|
| Rate for Payer: UHC Core |
$185.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$92.37
|
| Rate for Payer: UHC Exchange |
$185.34
|
| Rate for Payer: UHC Medicaid |
$60.07
|
| Rate for Payer: UHCCP Medicaid |
$60.07
|
|
|
PR NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL
|
Professional
|
Both
|
$218.00
|
|
|
Service Code
|
HCPCS 64491
|
| Min. Negotiated Rate |
$32.38 |
| Max. Negotiated Rate |
$163.50 |
| Rate for Payer: Aetna Commercial |
$67.58
|
| Rate for Payer: Aetna Medicare |
$52.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.62
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS MAPPO |
$50.43
|
| Rate for Payer: BCN Commercial |
$88.64
|
| Rate for Payer: BCN Medicare Advantage |
$50.43
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cofinity Commercial |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$67.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.43
|
| Rate for Payer: Healthscope Commercial |
$93.30
|
| Rate for Payer: Healthscope Commercial |
$80.69
|
| Rate for Payer: Mclaren Medicaid |
$32.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.95
|
| Rate for Payer: Meridian Medicaid |
$34.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.74
|
| Rate for Payer: Nomi Health Commercial |
$60.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.50
|
| Rate for Payer: PACE SWMI |
$50.43
|
| Rate for Payer: PHP Medicare Advantage |
$50.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$102.96
|
| Rate for Payer: Priority Health Medicare |
$50.43
|
| Rate for Payer: Priority Health SBD |
$102.96
|
| Rate for Payer: Priority Health Tiered Network |
$102.96
|
| Rate for Payer: Railroad Medicare Medicare |
$50.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.17
|
| Rate for Payer: UHC Core |
$106.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$50.43
|
| Rate for Payer: UHC Exchange |
$106.17
|
| Rate for Payer: UHC Medicaid |
$32.38
|
| Rate for Payer: UHCCP Medicaid |
$32.38
|
|
|
PR NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL
|
Professional
|
Both
|
$218.00
|
|
|
Service Code
|
HCPCS 64492
|
| Min. Negotiated Rate |
$32.59 |
| Max. Negotiated Rate |
$163.50 |
| Rate for Payer: Aetna Commercial |
$67.79
|
| Rate for Payer: Aetna Medicare |
$52.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.85
|
| Rate for Payer: BCBS Complete |
$34.22
|
| Rate for Payer: BCBS MAPPO |
$50.59
|
| Rate for Payer: BCN Commercial |
$89.14
|
| Rate for Payer: BCN Medicare Advantage |
$50.59
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cofinity Commercial |
$72.85
|
| Rate for Payer: Cofinity Commercial |
$67.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$93.59
|
| Rate for Payer: Healthscope Commercial |
$80.94
|
| Rate for Payer: Mclaren Medicaid |
$32.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.12
|
| Rate for Payer: Meridian Medicaid |
$34.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.42
|
| Rate for Payer: Nomi Health Commercial |
$60.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.50
|
| Rate for Payer: PACE SWMI |
$50.59
|
| Rate for Payer: PHP Medicare Advantage |
$50.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$103.53
|
| Rate for Payer: Priority Health Medicare |
$50.59
|
| Rate for Payer: Priority Health SBD |
$103.53
|
| Rate for Payer: Priority Health Tiered Network |
$103.53
|
| Rate for Payer: Railroad Medicare Medicare |
$50.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.32
|
| Rate for Payer: UHC Core |
$107.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$50.59
|
| Rate for Payer: UHC Exchange |
$107.32
|
| Rate for Payer: UHC Medicaid |
$32.59
|
| Rate for Payer: UHCCP Medicaid |
$32.59
|
|
|
PR NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 64493
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$186.75 |
| Rate for Payer: Aetna Commercial |
$106.82
|
| Rate for Payer: Aetna Medicare |
$82.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.80
|
| Rate for Payer: BCBS Complete |
$54.57
|
| Rate for Payer: BCBS MAPPO |
$79.72
|
| Rate for Payer: BCN Commercial |
$135.95
|
| Rate for Payer: BCN Medicare Advantage |
$79.72
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$114.80
|
| Rate for Payer: Cofinity Commercial |
$106.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.72
|
| Rate for Payer: Healthscope Commercial |
$147.48
|
| Rate for Payer: Healthscope Commercial |
$127.55
|
| Rate for Payer: Mclaren Medicaid |
$51.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.71
|
| Rate for Payer: Meridian Medicaid |
$54.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$87.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.33
|
| Rate for Payer: Nomi Health Commercial |
$95.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.75
|
| Rate for Payer: PACE SWMI |
$79.72
|
| Rate for Payer: PHP Medicare Advantage |
$79.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$157.91
|
| Rate for Payer: Priority Health Medicare |
$79.72
|
| Rate for Payer: Priority Health SBD |
$157.91
|
| Rate for Payer: Priority Health Tiered Network |
$157.91
|
| Rate for Payer: Railroad Medicare Medicare |
$79.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.04
|
| Rate for Payer: UHC Core |
$157.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$79.72
|
| Rate for Payer: UHC Exchange |
$157.04
|
| Rate for Payer: UHC Medicaid |
$51.97
|
| Rate for Payer: UHCCP Medicaid |
$51.97
|
|
|
PR NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL
|
Professional
|
Both
|
$172.00
|
|
|
Service Code
|
HCPCS 64494
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$129.00 |
| Rate for Payer: Aetna Commercial |
$58.12
|
| Rate for Payer: Aetna Medicare |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.45
|
| Rate for Payer: BCBS Complete |
$29.30
|
| Rate for Payer: BCBS MAPPO |
$43.37
|
| Rate for Payer: BCN Commercial |
$75.70
|
| Rate for Payer: BCN Medicare Advantage |
$43.37
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cash Price |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$62.45
|
| Rate for Payer: Cofinity Commercial |
$58.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.37
|
| Rate for Payer: Healthscope Commercial |
$80.23
|
| Rate for Payer: Healthscope Commercial |
$69.39
|
| Rate for Payer: Mclaren Medicaid |
$27.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.54
|
| Rate for Payer: Meridian Medicaid |
$29.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.34
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.00
|
| Rate for Payer: PACE SWMI |
$43.37
|
| Rate for Payer: PHP Medicare Advantage |
$43.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$87.92
|
| Rate for Payer: Priority Health Medicare |
$43.37
|
| Rate for Payer: Priority Health SBD |
$87.92
|
| Rate for Payer: Priority Health Tiered Network |
$87.92
|
| Rate for Payer: Railroad Medicare Medicare |
$43.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.42
|
| Rate for Payer: UHC Core |
$91.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$43.37
|
| Rate for Payer: UHC Exchange |
$91.42
|
| Rate for Payer: UHC Medicaid |
$27.90
|
| Rate for Payer: UHCCP Medicaid |
$27.90
|
|
|
PR NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 64495
|
| Min. Negotiated Rate |
$28.76 |
| Max. Negotiated Rate |
$132.00 |
| Rate for Payer: PHP Medicare Advantage |
$44.59
|
| Rate for Payer: Aetna Commercial |
$59.75
|
| Rate for Payer: Aetna Medicare |
$46.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.21
|
| Rate for Payer: BCBS Complete |
$30.20
|
| Rate for Payer: BCBS MAPPO |
$44.59
|
| Rate for Payer: BCN Commercial |
$76.19
|
| Rate for Payer: BCN Medicare Advantage |
$44.59
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cofinity Commercial |
$64.21
|
| Rate for Payer: Cofinity Commercial |
$59.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.59
|
| Rate for Payer: Healthscope Commercial |
$82.49
|
| Rate for Payer: Healthscope Commercial |
$71.34
|
| Rate for Payer: Mclaren Medicaid |
$28.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.82
|
| Rate for Payer: Meridian Medicaid |
$30.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.46
|
| Rate for Payer: Nomi Health Commercial |
$53.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.00
|
| Rate for Payer: PACE SWMI |
$44.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$88.49
|
| Rate for Payer: Priority Health Medicare |
$44.59
|
| Rate for Payer: Priority Health SBD |
$88.49
|
| Rate for Payer: Priority Health Tiered Network |
$88.49
|
| Rate for Payer: Railroad Medicare Medicare |
$44.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.57
|
| Rate for Payer: UHC Core |
$92.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.59
|
| Rate for Payer: UHC Exchange |
$92.57
|
| Rate for Payer: UHC Medicaid |
$28.76
|
| Rate for Payer: UHCCP Medicaid |
$28.76
|
|
|
PR NJX DX/THER SBST EPIDURAL/SUBARACH LUMBAR/SACRAL
|
Professional
|
Both
|
$781.00
|
|
|
Service Code
|
HCPCS 62311
|
| Min. Negotiated Rate |
$312.40 |
| Max. Negotiated Rate |
$585.75 |
| Rate for Payer: Aetna Medicare |
$390.50
|
| Rate for Payer: BCBS Complete |
$312.40
|
| Rate for Payer: Cash Price |
$624.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$585.75
|
|
|
PR NJX DX/THER SBST EPIDURAL/SUBRACH CERV/THORACIC
|
Professional
|
Both
|
$694.00
|
|
|
Service Code
|
HCPCS 62310
|
| Min. Negotiated Rate |
$277.60 |
| Max. Negotiated Rate |
$520.50 |
| Rate for Payer: Aetna Medicare |
$347.00
|
| Rate for Payer: BCBS Complete |
$277.60
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$520.50
|
|
|
PR NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN
|
Professional
|
Both
|
$348.00
|
|
|
Service Code
|
HCPCS 62321
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$261.00 |
| Rate for Payer: Aetna Commercial |
$126.01
|
| Rate for Payer: Aetna Medicare |
$97.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.42
|
| Rate for Payer: BCBS Complete |
$63.97
|
| Rate for Payer: BCBS MAPPO |
$94.04
|
| Rate for Payer: BCN Commercial |
$159.85
|
| Rate for Payer: BCN Medicare Advantage |
$94.04
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cofinity Commercial |
$135.42
|
| Rate for Payer: Cofinity Commercial |
$126.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.04
|
| Rate for Payer: Healthscope Commercial |
$173.97
|
| Rate for Payer: Healthscope Commercial |
$150.46
|
| Rate for Payer: Mclaren Medicaid |
$60.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.74
|
| Rate for Payer: Meridian Medicaid |
$63.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.54
|
| Rate for Payer: Nomi Health Commercial |
$112.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.00
|
| Rate for Payer: PACE SWMI |
$94.04
|
| Rate for Payer: PHP Medicare Advantage |
$94.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$185.66
|
| Rate for Payer: Priority Health Medicare |
$94.04
|
| Rate for Payer: Priority Health SBD |
$185.66
|
| Rate for Payer: Priority Health Tiered Network |
$185.66
|
| Rate for Payer: Railroad Medicare Medicare |
$94.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.91
|
| Rate for Payer: UHC Core |
$188.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$94.04
|
| Rate for Payer: UHC Exchange |
$188.91
|
| Rate for Payer: UHC Medicaid |
$60.92
|
| Rate for Payer: UHCCP Medicaid |
$60.92
|
|
|
PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN
|
Professional
|
Both
|
$317.00
|
|
|
Service Code
|
HCPCS 62323
|
| Min. Negotiated Rate |
$56.87 |
| Max. Negotiated Rate |
$237.75 |
| Rate for Payer: Aetna Commercial |
$117.60
|
| Rate for Payer: Aetna Medicare |
$91.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.37
|
| Rate for Payer: BCBS Complete |
$59.71
|
| Rate for Payer: BCBS MAPPO |
$87.76
|
| Rate for Payer: BCN Commercial |
$147.90
|
| Rate for Payer: BCN Medicare Advantage |
$87.76
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cofinity Commercial |
$126.37
|
| Rate for Payer: Cofinity Commercial |
$117.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.76
|
| Rate for Payer: Healthscope Commercial |
$162.36
|
| Rate for Payer: Healthscope Commercial |
$140.42
|
| Rate for Payer: Mclaren Medicaid |
$56.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.15
|
| Rate for Payer: Meridian Medicaid |
$59.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$96.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.84
|
| Rate for Payer: Nomi Health Commercial |
$105.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.75
|
| Rate for Payer: PACE SWMI |
$87.76
|
| Rate for Payer: PHP Medicare Advantage |
$87.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$171.79
|
| Rate for Payer: Priority Health Medicare |
$87.76
|
| Rate for Payer: Priority Health SBD |
$171.79
|
| Rate for Payer: Priority Health Tiered Network |
$171.79
|
| Rate for Payer: Railroad Medicare Medicare |
$87.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.89
|
| Rate for Payer: UHC Core |
$174.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$87.76
|
| Rate for Payer: UHC Exchange |
$174.89
|
| Rate for Payer: UHC Medicaid |
$56.87
|
| Rate for Payer: UHCCP Medicaid |
$56.87
|
|
|
PR NJX INFUS/BOLUS DX/SBST EDRL/SUBARACH LUM/SACRAL
|
Professional
|
Both
|
$898.00
|
|
|
Service Code
|
HCPCS 62319
|
| Min. Negotiated Rate |
$359.20 |
| Max. Negotiated Rate |
$673.50 |
| Rate for Payer: Aetna Medicare |
$449.00
|
| Rate for Payer: BCBS Complete |
$359.20
|
| Rate for Payer: Cash Price |
$718.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$673.50
|
|
|
PR NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS
|
Professional
|
Both
|
$2,936.00
|
|
|
Service Code
|
HCPCS 36466
|
| Min. Negotiated Rate |
$84.99 |
| Max. Negotiated Rate |
$2,202.00 |
| Rate for Payer: Aetna Commercial |
$180.16
|
| Rate for Payer: Aetna Medicare |
$139.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.61
|
| Rate for Payer: BCBS Complete |
$89.24
|
| Rate for Payer: BCBS MAPPO |
$134.45
|
| Rate for Payer: BCN Commercial |
$222.60
|
| Rate for Payer: BCN Medicare Advantage |
$134.45
|
| Rate for Payer: Cash Price |
$2,348.80
|
| Rate for Payer: Cash Price |
$2,348.80
|
| Rate for Payer: Cofinity Commercial |
$193.61
|
| Rate for Payer: Cofinity Commercial |
$180.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.45
|
| Rate for Payer: Healthscope Commercial |
$215.12
|
| Rate for Payer: Healthscope Commercial |
$248.73
|
| Rate for Payer: Mclaren Medicaid |
$84.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.17
|
| Rate for Payer: Meridian Medicaid |
$89.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.62
|
| Rate for Payer: Nomi Health Commercial |
$161.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,202.00
|
| Rate for Payer: PACE SWMI |
$134.45
|
| Rate for Payer: PHP Medicare Advantage |
$134.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$239.38
|
| Rate for Payer: Priority Health Medicare |
$134.45
|
| Rate for Payer: Priority Health SBD |
$239.38
|
| Rate for Payer: Priority Health Tiered Network |
$239.38
|
| Rate for Payer: Railroad Medicare Medicare |
$134.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.08
|
| Rate for Payer: UHC Core |
$275.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.45
|
| Rate for Payer: UHC Exchange |
$275.08
|
| Rate for Payer: UHC Medicaid |
$84.99
|
| Rate for Payer: UHCCP Medicaid |
$84.99
|
|
|
PR NJX NONCMPND SCLEROSANT SINGLE INCMPTNT VEIN
|
Professional
|
Both
|
$2,780.00
|
|
|
Service Code
|
HCPCS 36465
|
| Min. Negotiated Rate |
$67.31 |
| Max. Negotiated Rate |
$2,085.00 |
| Rate for Payer: Aetna Commercial |
$142.68
|
| Rate for Payer: Aetna Medicare |
$110.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.33
|
| Rate for Payer: BCBS Complete |
$70.68
|
| Rate for Payer: BCBS MAPPO |
$106.48
|
| Rate for Payer: BCN Commercial |
$176.28
|
| Rate for Payer: BCN Medicare Advantage |
$106.48
|
| Rate for Payer: Cash Price |
$2,224.00
|
| Rate for Payer: Cash Price |
$2,224.00
|
| Rate for Payer: Cofinity Commercial |
$153.33
|
| Rate for Payer: Cofinity Commercial |
$142.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.48
|
| Rate for Payer: Healthscope Commercial |
$196.99
|
| Rate for Payer: Healthscope Commercial |
$170.37
|
| Rate for Payer: Mclaren Medicaid |
$67.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.80
|
| Rate for Payer: Meridian Medicaid |
$70.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$117.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.56
|
| Rate for Payer: Nomi Health Commercial |
$127.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,085.00
|
| Rate for Payer: PACE SWMI |
$106.48
|
| Rate for Payer: PHP Medicare Advantage |
$106.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$189.58
|
| Rate for Payer: Priority Health Medicare |
$106.48
|
| Rate for Payer: Priority Health SBD |
$189.58
|
| Rate for Payer: Priority Health Tiered Network |
$189.58
|
| Rate for Payer: Railroad Medicare Medicare |
$106.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.92
|
| Rate for Payer: UHC Core |
$214.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$106.48
|
| Rate for Payer: UHC Exchange |
$214.92
|
| Rate for Payer: UHC Medicaid |
$67.31
|
| Rate for Payer: UHCCP Medicaid |
$67.31
|
|
|
PR NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION
|
Professional
|
Both
|
$946.00
|
|
|
Service Code
|
HCPCS 0232T
|
| Min. Negotiated Rate |
$78.68 |
| Max. Negotiated Rate |
$709.50 |
| Rate for Payer: Aetna Commercial |
$128.61
|
| Rate for Payer: Aetna Commercial |
$128.61
|
| Rate for Payer: Aetna Medicare |
$315.00
|
| Rate for Payer: Aetna Medicare |
$473.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.61
|
| Rate for Payer: BCBS Complete |
$252.00
|
| Rate for Payer: BCBS Complete |
$378.40
|
| Rate for Payer: BCN Commercial |
$373.10
|
| Rate for Payer: BCN Commercial |
$373.10
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$415.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$415.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$472.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$709.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$271.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$271.50
|
| Rate for Payer: Priority Health SBD |
$271.50
|
| Rate for Payer: Priority Health SBD |
$271.50
|
| Rate for Payer: Priority Health Tiered Network |
$271.50
|
| Rate for Payer: Priority Health Tiered Network |
$271.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.68
|
| Rate for Payer: UHC Core |
$78.68
|
| Rate for Payer: UHC Core |
$78.68
|
| Rate for Payer: UHC Exchange |
$78.68
|
| Rate for Payer: UHC Exchange |
$78.68
|
|
