|
PR DESTRUCTION PREMALIGNANT LESION 1ST
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 17000
|
| Min. Negotiated Rate |
$35.36 |
| Max. Negotiated Rate |
$534.35 |
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Medicare |
$54.60
|
| Rate for Payer: BCBS Complete |
$37.13
|
| Rate for Payer: BCBS MAPPO |
$52.50
|
| Rate for Payer: BCBS Trust/PPO |
$534.35
|
| Rate for Payer: BCN Commercial |
$78.92
|
| Rate for Payer: BCN Medicare Advantage |
$52.50
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$75.60
|
| Rate for Payer: Cofinity Commercial |
$70.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.50
|
| Rate for Payer: Mclaren Medicaid |
$35.36
|
| Rate for Payer: Meridian Medicaid |
$37.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.12
|
| Rate for Payer: PACE SWMI |
$52.50
|
| Rate for Payer: PHP Medicare Advantage |
$52.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.00
|
| Rate for Payer: Priority Health Medicare |
$52.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.50
|
| Rate for Payer: UHC Medicare Advantage |
$54.08
|
|
|
PR DESTRUCTION PREMALIGNANT LESION 2-14 EA
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 17003
|
| Min. Negotiated Rate |
$1.28 |
| Max. Negotiated Rate |
$2,756.25 |
| Rate for Payer: Aetna Commercial |
$2.64
|
| Rate for Payer: Aetna Medicare |
$2.05
|
| Rate for Payer: BCBS Complete |
$1.34
|
| Rate for Payer: BCBS MAPPO |
$1.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,756.25
|
| Rate for Payer: BCN Commercial |
$7.85
|
| Rate for Payer: BCN Medicare Advantage |
$1.97
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$2.84
|
| Rate for Payer: Cofinity Commercial |
$2.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.97
|
| Rate for Payer: Mclaren Medicaid |
$1.28
|
| Rate for Payer: Meridian Medicaid |
$1.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.07
|
| Rate for Payer: PACE SWMI |
$1.97
|
| Rate for Payer: PHP Medicare Advantage |
$1.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.46
|
| Rate for Payer: Priority Health Medicare |
$1.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.97
|
| Rate for Payer: UHC Medicare Advantage |
$2.03
|
|
|
PR DESTRUCTION RECTAL TUMOR TRANSANAL APPROACH
|
Professional
|
Both
|
$1,534.00
|
|
|
Service Code
|
HCPCS 45190
|
| Min. Negotiated Rate |
$446.66 |
| Max. Negotiated Rate |
$1,225.34 |
| Rate for Payer: Aetna Commercial |
$915.90
|
| Rate for Payer: Aetna Medicare |
$710.85
|
| Rate for Payer: BCBS Complete |
$468.99
|
| Rate for Payer: BCBS MAPPO |
$683.51
|
| Rate for Payer: BCBS Trust/PPO |
$706.34
|
| Rate for Payer: BCN Commercial |
$1,018.41
|
| Rate for Payer: BCN Medicare Advantage |
$683.51
|
| Rate for Payer: Cash Price |
$1,227.20
|
| Rate for Payer: Cash Price |
$1,227.20
|
| Rate for Payer: Cofinity Commercial |
$984.25
|
| Rate for Payer: Cofinity Commercial |
$915.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$683.51
|
| Rate for Payer: Mclaren Medicaid |
$446.66
|
| Rate for Payer: Meridian Medicaid |
$468.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$717.69
|
| Rate for Payer: PACE SWMI |
$683.51
|
| Rate for Payer: PHP Medicare Advantage |
$683.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$446.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,073.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,225.34
|
| Rate for Payer: Priority Health Medicare |
$683.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,225.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$683.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$683.51
|
| Rate for Payer: UHC Medicare Advantage |
$704.02
|
|
|
PR DESTRUCTION VAGINAL LESIONS EXTENSIVE
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 57065
|
| Min. Negotiated Rate |
$119.92 |
| Max. Negotiated Rate |
$2,603.46 |
| Rate for Payer: Aetna Commercial |
$245.64
|
| Rate for Payer: Aetna Medicare |
$190.64
|
| Rate for Payer: BCBS Complete |
$125.92
|
| Rate for Payer: BCBS MAPPO |
$183.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,603.46
|
| Rate for Payer: BCN Commercial |
$365.04
|
| Rate for Payer: BCN Medicare Advantage |
$183.31
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$245.64
|
| Rate for Payer: Cofinity Commercial |
$263.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.31
|
| Rate for Payer: Mclaren Medicaid |
$119.92
|
| Rate for Payer: Meridian Medicaid |
$125.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$192.48
|
| Rate for Payer: PACE SWMI |
$183.31
|
| Rate for Payer: PHP Medicare Advantage |
$183.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$499.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$265.12
|
| Rate for Payer: Priority Health Medicare |
$183.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$265.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.31
|
| Rate for Payer: UHC Medicare Advantage |
$188.81
|
|
|
PR DESTRUCTION VAGINAL LESIONS SIMPLE
|
Professional
|
Both
|
$355.00
|
|
|
Service Code
|
HCPCS 57061
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$2,929.42 |
| Rate for Payer: Aetna Commercial |
$150.86
|
| Rate for Payer: Aetna Medicare |
$117.08
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: BCBS MAPPO |
$112.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,929.42
|
| Rate for Payer: BCN Commercial |
$199.08
|
| Rate for Payer: BCN Medicare Advantage |
$112.58
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cash Price |
$284.00
|
| Rate for Payer: Cofinity Commercial |
$150.86
|
| Rate for Payer: Cofinity Commercial |
$162.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.58
|
| Rate for Payer: Mclaren Medicaid |
$74.55
|
| Rate for Payer: Meridian Medicaid |
$78.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$118.21
|
| Rate for Payer: PACE SWMI |
$112.58
|
| Rate for Payer: PHP Medicare Advantage |
$112.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$164.76
|
| Rate for Payer: Priority Health Medicare |
$112.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.58
|
| Rate for Payer: UHC Medicare Advantage |
$115.96
|
|
|
PR DETERMINATION REFRACTIVE STATE
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 92015
|
| Min. Negotiated Rate |
$11.72 |
| Max. Negotiated Rate |
$1,164.90 |
| Rate for Payer: Aetna Commercial |
$21.33
|
| Rate for Payer: BCBS Complete |
$12.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,164.90
|
| Rate for Payer: BCN Commercial |
$20.42
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Mclaren Medicaid |
$11.72
|
| Rate for Payer: Meridian Medicaid |
$12.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.08
|
|
|
PR DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS 96110
|
| Min. Negotiated Rate |
$10.35 |
| Max. Negotiated Rate |
$974.19 |
| Rate for Payer: Aetna Commercial |
$10.35
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$974.19
|
| Rate for Payer: BCN Commercial |
$15.64
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.37
|
|
|
PR DEVELOPMENTAL TESTING W/INTERP & REPORT
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 96111
|
| Min. Negotiated Rate |
$94.80 |
| Max. Negotiated Rate |
$165.90 |
| Rate for Payer: BCBS Complete |
$94.80
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.90
|
|
|
PR DEXAMETHASONE SODIUM PHOS
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J1100
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$7.00 |
| Rate for Payer: Aetna Commercial |
$0.16
|
| Rate for Payer: Aetna Medicare |
$0.13
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$0.12
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: BCN Medicare Advantage |
$0.12
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$0.16
|
| Rate for Payer: Cofinity Commercial |
$0.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.13
|
| Rate for Payer: PACE SWMI |
$0.12
|
| Rate for Payer: PHP Medicare Advantage |
$0.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.00
|
| Rate for Payer: Priority Health Medicare |
$0.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.12
|
| Rate for Payer: UHC Medicare Advantage |
$0.13
|
|
|
PR DIABETES PREVENTION PROGRAM
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 00268
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$52.00 |
| Max. Negotiated Rate |
$91.00 |
| Rate for Payer: BCBS Complete |
$52.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.00
|
|
|
PR DIABETES PREVENTION PROG STANDARDIZED CURRICULUM
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 0403T
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$131.11 |
| Rate for Payer: Aetna Commercial |
$32.06
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS Trust/PPO |
$131.11
|
| Rate for Payer: BCN Commercial |
$58.68
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.40
|
|
|
PR DIAGNOSTIC ARTHROSCOPY SHOULDER +- SYNOVIAL BX
|
Professional
|
Both
|
$1,269.00
|
|
|
Service Code
|
HCPCS 29805
|
| Min. Negotiated Rate |
$303.74 |
| Max. Negotiated Rate |
$888.30 |
| Rate for Payer: Aetna Commercial |
$619.16
|
| Rate for Payer: Aetna Medicare |
$480.54
|
| Rate for Payer: BCBS Complete |
$318.93
|
| Rate for Payer: BCBS MAPPO |
$462.06
|
| Rate for Payer: BCBS Trust/PPO |
$667.24
|
| Rate for Payer: BCN Commercial |
$692.46
|
| Rate for Payer: BCN Medicare Advantage |
$462.06
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cash Price |
$1,015.20
|
| Rate for Payer: Cofinity Commercial |
$619.16
|
| Rate for Payer: Cofinity Commercial |
$665.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$462.06
|
| Rate for Payer: Mclaren Medicaid |
$303.74
|
| Rate for Payer: Meridian Medicaid |
$318.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$485.16
|
| Rate for Payer: PACE SWMI |
$462.06
|
| Rate for Payer: PHP Medicare Advantage |
$462.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$303.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$888.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$723.59
|
| Rate for Payer: Priority Health Medicare |
$462.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$723.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$462.06
|
| Rate for Payer: UHC Medicare Advantage |
$475.92
|
|
|
PR DIAGNOSTIC BONE MARROW ASPIRATIONS
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
HCPCS 38220
|
| Min. Negotiated Rate |
$42.39 |
| Max. Negotiated Rate |
$437.96 |
| Rate for Payer: Aetna Commercial |
$88.33
|
| Rate for Payer: Aetna Medicare |
$68.56
|
| Rate for Payer: BCBS Complete |
$44.51
|
| Rate for Payer: BCBS MAPPO |
$65.92
|
| Rate for Payer: BCBS Trust/PPO |
$437.96
|
| Rate for Payer: BCN Commercial |
$226.75
|
| Rate for Payer: BCN Medicare Advantage |
$65.92
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cofinity Commercial |
$94.92
|
| Rate for Payer: Cofinity Commercial |
$88.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.92
|
| Rate for Payer: Mclaren Medicaid |
$42.39
|
| Rate for Payer: Meridian Medicaid |
$44.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.22
|
| Rate for Payer: PACE SWMI |
$65.92
|
| Rate for Payer: PHP Medicare Advantage |
$65.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.86
|
| Rate for Payer: Priority Health Medicare |
$65.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.92
|
| Rate for Payer: UHC Medicare Advantage |
$67.90
|
|
|
PR DIAGNOSTIC BONE MARROW BIOPSIES
|
Professional
|
Both
|
$360.00
|
|
|
Service Code
|
HCPCS 38221
|
| Min. Negotiated Rate |
$44.30 |
| Max. Negotiated Rate |
$400.45 |
| Rate for Payer: Aetna Commercial |
$91.55
|
| Rate for Payer: Aetna Medicare |
$71.05
|
| Rate for Payer: BCBS Complete |
$46.52
|
| Rate for Payer: BCBS MAPPO |
$68.32
|
| Rate for Payer: BCBS Trust/PPO |
$400.45
|
| Rate for Payer: BCN Commercial |
$235.54
|
| Rate for Payer: BCN Medicare Advantage |
$68.32
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cofinity Commercial |
$98.38
|
| Rate for Payer: Cofinity Commercial |
$91.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.32
|
| Rate for Payer: Mclaren Medicaid |
$44.30
|
| Rate for Payer: Meridian Medicaid |
$46.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$71.74
|
| Rate for Payer: PACE SWMI |
$68.32
|
| Rate for Payer: PHP Medicare Advantage |
$68.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.95
|
| Rate for Payer: Priority Health Medicare |
$68.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.32
|
| Rate for Payer: UHC Medicare Advantage |
$70.37
|
|
|
PR DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS
|
Professional
|
Both
|
$380.00
|
|
|
Service Code
|
HCPCS 38222
|
| Min. Negotiated Rate |
$47.29 |
| Max. Negotiated Rate |
$367.17 |
| Rate for Payer: Aetna Commercial |
$98.97
|
| Rate for Payer: Aetna Medicare |
$76.81
|
| Rate for Payer: BCBS Complete |
$49.65
|
| Rate for Payer: BCBS MAPPO |
$73.86
|
| Rate for Payer: BCBS Trust/PPO |
$367.17
|
| Rate for Payer: BCN Commercial |
$255.58
|
| Rate for Payer: BCN Medicare Advantage |
$73.86
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cofinity Commercial |
$98.97
|
| Rate for Payer: Cofinity Commercial |
$106.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.86
|
| Rate for Payer: Mclaren Medicaid |
$47.29
|
| Rate for Payer: Meridian Medicaid |
$49.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.55
|
| Rate for Payer: PACE SWMI |
$73.86
|
| Rate for Payer: PHP Medicare Advantage |
$73.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.53
|
| Rate for Payer: Priority Health Medicare |
$73.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$161.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.86
|
| Rate for Payer: UHC Medicare Advantage |
$76.08
|
|
|
PR DIAGNOSTIC LUMBAR SPINAL PUNCTURE
|
Professional
|
Both
|
$555.00
|
|
|
Service Code
|
HCPCS 62270
|
| Min. Negotiated Rate |
$40.47 |
| Max. Negotiated Rate |
$874.34 |
| Rate for Payer: Aetna Commercial |
$83.60
|
| Rate for Payer: Aetna Medicare |
$64.89
|
| Rate for Payer: BCBS Complete |
$42.49
|
| Rate for Payer: BCBS MAPPO |
$62.39
|
| Rate for Payer: BCBS Trust/PPO |
$874.34
|
| Rate for Payer: BCN Commercial |
$194.49
|
| Rate for Payer: BCN Medicare Advantage |
$62.39
|
| Rate for Payer: Cash Price |
$444.00
|
| Rate for Payer: Cash Price |
$444.00
|
| Rate for Payer: Cofinity Commercial |
$89.84
|
| Rate for Payer: Cofinity Commercial |
$83.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.39
|
| Rate for Payer: Mclaren Medicaid |
$40.47
|
| Rate for Payer: Meridian Medicaid |
$42.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.51
|
| Rate for Payer: PACE SWMI |
$62.39
|
| Rate for Payer: PHP Medicare Advantage |
$62.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$388.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.32
|
| Rate for Payer: Priority Health Medicare |
$62.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.39
|
| Rate for Payer: UHC Medicare Advantage |
$64.26
|
|
|
PR DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
HCPCS 62328
|
| Min. Negotiated Rate |
$53.68 |
| Max. Negotiated Rate |
$1,578.56 |
| Rate for Payer: Aetna Commercial |
$113.90
|
| Rate for Payer: Aetna Medicare |
$88.40
|
| Rate for Payer: BCBS Complete |
$56.36
|
| Rate for Payer: BCBS MAPPO |
$85.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,578.56
|
| Rate for Payer: BCN Commercial |
$339.63
|
| Rate for Payer: BCN Medicare Advantage |
$85.00
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cofinity Commercial |
$113.90
|
| Rate for Payer: Cofinity Commercial |
$122.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.00
|
| Rate for Payer: Mclaren Medicaid |
$53.68
|
| Rate for Payer: Meridian Medicaid |
$56.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$89.25
|
| Rate for Payer: PACE SWMI |
$85.00
|
| Rate for Payer: PHP Medicare Advantage |
$85.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.38
|
| Rate for Payer: Priority Health Medicare |
$85.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$144.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.00
|
| Rate for Payer: UHC Medicare Advantage |
$87.55
|
|
|
PR DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I
|
Professional
|
Both
|
$1,512.00
|
|
|
Service Code
|
HCPCS 36909
|
| Min. Negotiated Rate |
$124.61 |
| Max. Negotiated Rate |
$2,818.21 |
| Rate for Payer: Aetna Commercial |
$263.94
|
| Rate for Payer: Aetna Medicare |
$204.85
|
| Rate for Payer: BCBS Complete |
$130.84
|
| Rate for Payer: BCBS MAPPO |
$196.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,517.28
|
| Rate for Payer: BCN Commercial |
$2,818.21
|
| Rate for Payer: BCN Medicare Advantage |
$196.97
|
| Rate for Payer: Cash Price |
$1,209.60
|
| Rate for Payer: Cash Price |
$1,209.60
|
| Rate for Payer: Cofinity Commercial |
$283.64
|
| Rate for Payer: Cofinity Commercial |
$263.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.97
|
| Rate for Payer: Mclaren Medicaid |
$124.61
|
| Rate for Payer: Meridian Medicaid |
$130.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$206.82
|
| Rate for Payer: PACE SWMI |
$196.97
|
| Rate for Payer: PHP Medicare Advantage |
$196.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,058.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$311.73
|
| Rate for Payer: Priority Health Medicare |
$196.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$311.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.97
|
| Rate for Payer: UHC Medicare Advantage |
$202.88
|
|
|
PR DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL
|
Professional
|
Both
|
$205.00
|
|
|
Service Code
|
HCPCS 90945
|
| Min. Negotiated Rate |
$54.10 |
| Max. Negotiated Rate |
$370.34 |
| Rate for Payer: Aetna Commercial |
$111.30
|
| Rate for Payer: Aetna Medicare |
$86.38
|
| Rate for Payer: BCBS Complete |
$56.80
|
| Rate for Payer: BCBS MAPPO |
$83.06
|
| Rate for Payer: BCBS Trust/PPO |
$370.34
|
| Rate for Payer: BCN Commercial |
$123.15
|
| Rate for Payer: BCN Medicare Advantage |
$83.06
|
| Rate for Payer: Cash Price |
$164.00
|
| Rate for Payer: Cash Price |
$164.00
|
| Rate for Payer: Cofinity Commercial |
$111.30
|
| Rate for Payer: Cofinity Commercial |
$119.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.06
|
| Rate for Payer: Mclaren Medicaid |
$54.10
|
| Rate for Payer: Meridian Medicaid |
$56.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.21
|
| Rate for Payer: PACE SWMI |
$83.06
|
| Rate for Payer: PHP Medicare Advantage |
$83.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.19
|
| Rate for Payer: Priority Health Medicare |
$83.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.06
|
| Rate for Payer: UHC Medicare Advantage |
$85.55
|
|
|
PR DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 90947
|
| Min. Negotiated Rate |
$77.11 |
| Max. Negotiated Rate |
$319.62 |
| Rate for Payer: Aetna Commercial |
$160.87
|
| Rate for Payer: Aetna Medicare |
$124.85
|
| Rate for Payer: BCBS Complete |
$80.97
|
| Rate for Payer: BCBS MAPPO |
$120.05
|
| Rate for Payer: BCBS Trust/PPO |
$319.62
|
| Rate for Payer: BCN Commercial |
$176.42
|
| Rate for Payer: BCN Medicare Advantage |
$120.05
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$172.87
|
| Rate for Payer: Cofinity Commercial |
$160.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.05
|
| Rate for Payer: Mclaren Medicaid |
$77.11
|
| Rate for Payer: Meridian Medicaid |
$80.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.05
|
| Rate for Payer: PACE SWMI |
$120.05
|
| Rate for Payer: PHP Medicare Advantage |
$120.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$162.14
|
| Rate for Payer: Priority Health Medicare |
$120.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.05
|
| Rate for Payer: UHC Medicare Advantage |
$123.65
|
|
|
PR DIAPHRAGM
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
HCPCS A4266
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: Aetna Commercial |
$32.28
|
| Rate for Payer: BCBS Complete |
$28.00
|
| Rate for Payer: BCN Commercial |
$80.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.00
|
|
|
PR DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS
|
Professional
|
Both
|
$223.00
|
|
|
Service Code
|
HCPCS 57170
|
| Min. Negotiated Rate |
$30.03 |
| Max. Negotiated Rate |
$2,039.77 |
| Rate for Payer: Aetna Commercial |
$64.11
|
| Rate for Payer: Aetna Medicare |
$49.75
|
| Rate for Payer: BCBS Complete |
$31.53
|
| Rate for Payer: BCBS MAPPO |
$47.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,039.77
|
| Rate for Payer: BCN Commercial |
$115.33
|
| Rate for Payer: BCN Medicare Advantage |
$47.84
|
| Rate for Payer: Cash Price |
$178.40
|
| Rate for Payer: Cash Price |
$178.40
|
| Rate for Payer: Cofinity Commercial |
$64.11
|
| Rate for Payer: Cofinity Commercial |
$68.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.84
|
| Rate for Payer: Mclaren Medicaid |
$30.03
|
| Rate for Payer: Meridian Medicaid |
$31.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.23
|
| Rate for Payer: PACE SWMI |
$47.84
|
| Rate for Payer: PHP Medicare Advantage |
$47.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.70
|
| Rate for Payer: Priority Health Medicare |
$47.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.84
|
| Rate for Payer: UHC Medicare Advantage |
$49.28
|
|
|
PR DIGITAL ANALYSIS ELECTROENCEPHALOGRAM
|
Professional
|
Both
|
$763.00
|
|
|
Service Code
|
HCPCS 95957
|
| Min. Negotiated Rate |
$260.40 |
| Max. Negotiated Rate |
$534.10 |
| Rate for Payer: Aetna Commercial |
$348.94
|
| Rate for Payer: Aetna Medicare |
$270.82
|
| Rate for Payer: BCBS Complete |
$305.20
|
| Rate for Payer: BCBS MAPPO |
$260.40
|
| Rate for Payer: BCBS Trust/PPO |
$346.56
|
| Rate for Payer: BCN Commercial |
$401.69
|
| Rate for Payer: BCN Medicare Advantage |
$260.40
|
| Rate for Payer: Cash Price |
$610.40
|
| Rate for Payer: Cash Price |
$610.40
|
| Rate for Payer: Cofinity Commercial |
$374.98
|
| Rate for Payer: Cofinity Commercial |
$348.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$273.42
|
| Rate for Payer: PACE SWMI |
$260.40
|
| Rate for Payer: PHP Medicare Advantage |
$260.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$534.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$369.19
|
| Rate for Payer: Priority Health Medicare |
$260.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$369.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$260.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.40
|
| Rate for Payer: UHC Medicare Advantage |
$268.21
|
|
|
PR DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL
|
Professional
|
Both
|
$352.00
|
|
|
Service Code
|
HCPCS 45905
|
| Min. Negotiated Rate |
$109.48 |
| Max. Negotiated Rate |
$585.88 |
| Rate for Payer: Aetna Commercial |
$223.62
|
| Rate for Payer: Aetna Medicare |
$173.56
|
| Rate for Payer: BCBS Complete |
$114.95
|
| Rate for Payer: BCBS MAPPO |
$166.88
|
| Rate for Payer: BCBS Trust/PPO |
$585.88
|
| Rate for Payer: BCN Commercial |
$249.22
|
| Rate for Payer: BCN Medicare Advantage |
$166.88
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cofinity Commercial |
$240.31
|
| Rate for Payer: Cofinity Commercial |
$223.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.88
|
| Rate for Payer: Mclaren Medicaid |
$109.48
|
| Rate for Payer: Meridian Medicaid |
$114.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$175.22
|
| Rate for Payer: PACE SWMI |
$166.88
|
| Rate for Payer: PHP Medicare Advantage |
$166.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$299.86
|
| Rate for Payer: Priority Health Medicare |
$166.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$299.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$166.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$166.88
|
| Rate for Payer: UHC Medicare Advantage |
$171.89
|
|
|
PR DILAT&CATHJ SALIVARY DUCT W/WO INJECTION
|
Professional
|
Both
|
$223.00
|
|
|
Service Code
|
HCPCS 42660
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$1,102.03 |
| Rate for Payer: Aetna Commercial |
$116.51
|
| Rate for Payer: Aetna Medicare |
$90.43
|
| Rate for Payer: BCBS Complete |
$58.15
|
| Rate for Payer: BCBS MAPPO |
$86.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,102.03
|
| Rate for Payer: BCN Commercial |
$172.01
|
| Rate for Payer: BCN Medicare Advantage |
$86.95
|
| Rate for Payer: Cash Price |
$178.40
|
| Rate for Payer: Cash Price |
$178.40
|
| Rate for Payer: Cofinity Commercial |
$125.21
|
| Rate for Payer: Cofinity Commercial |
$116.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.95
|
| Rate for Payer: Mclaren Medicaid |
$55.38
|
| Rate for Payer: Meridian Medicaid |
$58.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.30
|
| Rate for Payer: PACE SWMI |
$86.95
|
| Rate for Payer: PHP Medicare Advantage |
$86.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$155.81
|
| Rate for Payer: Priority Health Medicare |
$86.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.95
|
| Rate for Payer: UHC Medicare Advantage |
$89.56
|
|
