|
PR ESOPHAGOSCOPY TRANSORAL STENT PLACEMENT
|
Professional
|
Both
|
$563.00
|
|
|
Service Code
|
HCPCS 43212
|
| Min. Negotiated Rate |
$118.85 |
| Max. Negotiated Rate |
$394.10 |
| Rate for Payer: Aetna Commercial |
$248.92
|
| Rate for Payer: Aetna Medicare |
$193.19
|
| Rate for Payer: BCBS Complete |
$124.79
|
| Rate for Payer: BCBS MAPPO |
$185.76
|
| Rate for Payer: BCBS Trust/PPO |
$156.91
|
| Rate for Payer: BCN Commercial |
$272.68
|
| Rate for Payer: BCN Medicare Advantage |
$185.76
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cash Price |
$450.40
|
| Rate for Payer: Cofinity Commercial |
$248.92
|
| Rate for Payer: Cofinity Commercial |
$267.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.76
|
| Rate for Payer: Mclaren Medicaid |
$118.85
|
| Rate for Payer: Meridian Medicaid |
$124.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$195.05
|
| Rate for Payer: PACE SWMI |
$185.76
|
| Rate for Payer: PHP Medicare Advantage |
$185.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$394.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$328.09
|
| Rate for Payer: Priority Health Medicare |
$185.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$328.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.76
|
| Rate for Payer: UHC Medicare Advantage |
$191.33
|
|
|
PR ESOPHAGOSCP RIG TRANSORAL HYPOPHARYNX CRV ESOPH
|
Professional
|
Both
|
$1,296.00
|
|
|
Service Code
|
HCPCS 43180
|
| Min. Negotiated Rate |
$66.57 |
| Max. Negotiated Rate |
$962.51 |
| Rate for Payer: Aetna Commercial |
$723.57
|
| Rate for Payer: Aetna Medicare |
$561.58
|
| Rate for Payer: BCBS Complete |
$367.91
|
| Rate for Payer: BCBS MAPPO |
$539.98
|
| Rate for Payer: BCBS Trust/PPO |
$66.57
|
| Rate for Payer: BCN Commercial |
$799.97
|
| Rate for Payer: BCN Medicare Advantage |
$539.98
|
| Rate for Payer: Cash Price |
$1,036.80
|
| Rate for Payer: Cash Price |
$1,036.80
|
| Rate for Payer: Cofinity Commercial |
$777.57
|
| Rate for Payer: Cofinity Commercial |
$723.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$539.98
|
| Rate for Payer: Mclaren Medicaid |
$350.39
|
| Rate for Payer: Meridian Medicaid |
$367.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$566.98
|
| Rate for Payer: PACE SWMI |
$539.98
|
| Rate for Payer: PHP Medicare Advantage |
$539.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$350.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$907.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$962.51
|
| Rate for Payer: Priority Health Medicare |
$539.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$962.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$539.98
|
| Rate for Payer: UHC Medicare Advantage |
$556.18
|
|
|
PR ESOPHAGOSTOMY FSTLJ ESOPH XTRNL CRV APPR
|
Professional
|
Both
|
$2,342.00
|
|
|
Service Code
|
HCPCS 43352
|
| Min. Negotiated Rate |
$676.91 |
| Max. Negotiated Rate |
$1,857.41 |
| Rate for Payer: Aetna Commercial |
$1,410.99
|
| Rate for Payer: Aetna Medicare |
$1,095.10
|
| Rate for Payer: BCBS Complete |
$710.76
|
| Rate for Payer: BCBS MAPPO |
$1,052.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,158.75
|
| Rate for Payer: BCN Commercial |
$1,543.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,052.98
|
| Rate for Payer: Cash Price |
$1,873.60
|
| Rate for Payer: Cash Price |
$1,873.60
|
| Rate for Payer: Cofinity Commercial |
$1,516.29
|
| Rate for Payer: Cofinity Commercial |
$1,410.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,052.98
|
| Rate for Payer: Mclaren Medicaid |
$676.91
|
| Rate for Payer: Meridian Medicaid |
$710.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,105.63
|
| Rate for Payer: PACE SWMI |
$1,052.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,052.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$676.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,639.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,857.41
|
| Rate for Payer: Priority Health Medicare |
$1,052.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,857.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,052.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,052.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,084.57
|
|
|
PR ESOPHAGOSTOMY FSTLJ ESOPH XTRNL THRC APPR
|
Professional
|
Both
|
$3,468.00
|
|
|
Service Code
|
HCPCS 43351
|
| Min. Negotiated Rate |
$836.45 |
| Max. Negotiated Rate |
$2,427.60 |
| Rate for Payer: Aetna Commercial |
$1,741.66
|
| Rate for Payer: Aetna Medicare |
$1,351.74
|
| Rate for Payer: BCBS Complete |
$878.27
|
| Rate for Payer: BCBS MAPPO |
$1,299.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,088.94
|
| Rate for Payer: BCN Commercial |
$1,905.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,299.75
|
| Rate for Payer: Cash Price |
$2,774.40
|
| Rate for Payer: Cash Price |
$2,774.40
|
| Rate for Payer: Cofinity Commercial |
$1,741.66
|
| Rate for Payer: Cofinity Commercial |
$1,871.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,299.75
|
| Rate for Payer: Mclaren Medicaid |
$836.45
|
| Rate for Payer: Meridian Medicaid |
$878.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,364.74
|
| Rate for Payer: PACE SWMI |
$1,299.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,299.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,427.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,292.50
|
| Rate for Payer: Priority Health Medicare |
$1,299.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,292.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,299.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,299.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,338.74
|
|
|
PR ESOPHAGOTOMY THORACIC APPR W/RMVL FB
|
Professional
|
Both
|
$3,212.00
|
|
|
Service Code
|
HCPCS 43045
|
| Min. Negotiated Rate |
$272.07 |
| Max. Negotiated Rate |
$2,266.63 |
| Rate for Payer: Aetna Commercial |
$1,722.62
|
| Rate for Payer: Aetna Medicare |
$1,336.96
|
| Rate for Payer: BCBS Complete |
$867.76
|
| Rate for Payer: BCBS MAPPO |
$1,285.54
|
| Rate for Payer: BCBS Trust/PPO |
$272.07
|
| Rate for Payer: BCN Commercial |
$1,883.86
|
| Rate for Payer: BCN Medicare Advantage |
$1,285.54
|
| Rate for Payer: Cash Price |
$2,569.60
|
| Rate for Payer: Cash Price |
$2,569.60
|
| Rate for Payer: Cofinity Commercial |
$1,851.18
|
| Rate for Payer: Cofinity Commercial |
$1,722.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,285.54
|
| Rate for Payer: Mclaren Medicaid |
$826.44
|
| Rate for Payer: Meridian Medicaid |
$867.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,349.82
|
| Rate for Payer: PACE SWMI |
$1,285.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,285.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$826.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,248.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,266.63
|
| Rate for Payer: Priority Health Medicare |
$1,285.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,266.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,285.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,285.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,324.11
|
|
|
PR ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
HCPCS 91038
|
| Min. Negotiated Rate |
$44.40 |
| Max. Negotiated Rate |
$932.98 |
| Rate for Payer: Aetna Commercial |
$512.05
|
| Rate for Payer: Aetna Commercial |
$512.05
|
| Rate for Payer: Aetna Medicare |
$397.42
|
| Rate for Payer: Aetna Medicare |
$397.42
|
| Rate for Payer: BCBS Complete |
$321.20
|
| Rate for Payer: BCBS Complete |
$44.40
|
| Rate for Payer: BCBS MAPPO |
$382.13
|
| Rate for Payer: BCBS MAPPO |
$382.13
|
| Rate for Payer: BCBS Trust/PPO |
$932.98
|
| Rate for Payer: BCBS Trust/PPO |
$932.98
|
| Rate for Payer: BCN Commercial |
$599.12
|
| Rate for Payer: BCN Commercial |
$599.12
|
| Rate for Payer: BCN Medicare Advantage |
$382.13
|
| Rate for Payer: BCN Medicare Advantage |
$382.13
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cofinity Commercial |
$512.05
|
| Rate for Payer: Cofinity Commercial |
$512.05
|
| Rate for Payer: Cofinity Commercial |
$550.27
|
| Rate for Payer: Cofinity Commercial |
$550.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$401.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$401.24
|
| Rate for Payer: PACE SWMI |
$382.13
|
| Rate for Payer: PACE SWMI |
$382.13
|
| Rate for Payer: PHP Medicare Advantage |
$382.13
|
| Rate for Payer: PHP Medicare Advantage |
$382.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$550.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$550.65
|
| Rate for Payer: Priority Health Medicare |
$382.13
|
| Rate for Payer: Priority Health Medicare |
$382.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$550.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$550.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$382.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$382.13
|
| Rate for Payer: UHC Medicare Advantage |
$393.59
|
| Rate for Payer: UHC Medicare Advantage |
$393.59
|
|
|
PR ESPHAGOSCOPY FLEX LESION REMOVAL HOT BX FORCEPS
|
Professional
|
Both
|
$1,147.00
|
|
|
Service Code
|
HCPCS 43216
|
| Min. Negotiated Rate |
$84.14 |
| Max. Negotiated Rate |
$802.90 |
| Rate for Payer: Aetna Commercial |
$173.06
|
| Rate for Payer: Aetna Medicare |
$134.32
|
| Rate for Payer: BCBS Complete |
$88.35
|
| Rate for Payer: BCBS MAPPO |
$129.15
|
| Rate for Payer: BCBS Trust/PPO |
$137.36
|
| Rate for Payer: BCN Commercial |
$603.52
|
| Rate for Payer: BCN Medicare Advantage |
$129.15
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cash Price |
$917.60
|
| Rate for Payer: Cofinity Commercial |
$185.98
|
| Rate for Payer: Cofinity Commercial |
$173.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.15
|
| Rate for Payer: Mclaren Medicaid |
$84.14
|
| Rate for Payer: Meridian Medicaid |
$88.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$135.61
|
| Rate for Payer: PACE SWMI |
$129.15
|
| Rate for Payer: PHP Medicare Advantage |
$129.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$802.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$229.90
|
| Rate for Payer: Priority Health Medicare |
$129.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$229.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.15
|
| Rate for Payer: UHC Medicare Advantage |
$133.02
|
|
|
PR ESPHGOSCOPY FLEX W/BAND LIGATION ESOPHGL VARICES
|
Professional
|
Both
|
$1,082.00
|
|
|
Service Code
|
HCPCS 43205
|
| Min. Negotiated Rate |
$88.82 |
| Max. Negotiated Rate |
$757.40 |
| Rate for Payer: Aetna Commercial |
$182.74
|
| Rate for Payer: Aetna Medicare |
$141.82
|
| Rate for Payer: BCBS Complete |
$93.26
|
| Rate for Payer: BCBS MAPPO |
$136.37
|
| Rate for Payer: BCBS Trust/PPO |
$278.94
|
| Rate for Payer: BCN Commercial |
$201.83
|
| Rate for Payer: BCN Medicare Advantage |
$136.37
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cash Price |
$865.60
|
| Rate for Payer: Cofinity Commercial |
$196.37
|
| Rate for Payer: Cofinity Commercial |
$182.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.37
|
| Rate for Payer: Mclaren Medicaid |
$88.82
|
| Rate for Payer: Meridian Medicaid |
$93.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$143.19
|
| Rate for Payer: PACE SWMI |
$136.37
|
| Rate for Payer: PHP Medicare Advantage |
$136.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$242.83
|
| Rate for Payer: Priority Health Medicare |
$136.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$242.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$136.37
|
| Rate for Payer: UHC Medicare Advantage |
$140.46
|
|
|
PR ESPHGP CGEN DFCT THRC APPR W/O RPR FSTL
|
Professional
|
Both
|
$6,527.00
|
|
|
Service Code
|
HCPCS 43313
|
| Min. Negotiated Rate |
$1,290.11 |
| Max. Negotiated Rate |
$5,080.67 |
| Rate for Payer: Aetna Commercial |
$3,861.48
|
| Rate for Payer: Aetna Medicare |
$2,996.97
|
| Rate for Payer: BCBS Complete |
$1,943.97
|
| Rate for Payer: BCBS MAPPO |
$2,881.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,290.11
|
| Rate for Payer: BCN Commercial |
$4,222.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,881.70
|
| Rate for Payer: Cash Price |
$5,221.60
|
| Rate for Payer: Cash Price |
$5,221.60
|
| Rate for Payer: Cofinity Commercial |
$3,861.48
|
| Rate for Payer: Cofinity Commercial |
$4,149.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,881.70
|
| Rate for Payer: Mclaren Medicaid |
$1,851.40
|
| Rate for Payer: Meridian Medicaid |
$1,943.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,025.78
|
| Rate for Payer: PACE SWMI |
$2,881.70
|
| Rate for Payer: PHP Medicare Advantage |
$2,881.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,851.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,568.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,080.67
|
| Rate for Payer: Priority Health Medicare |
$2,881.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,080.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,881.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,881.70
|
| Rate for Payer: UHC Medicare Advantage |
$2,968.15
|
|
|
PR ESPHGP CGEN DFCT THRC APPR W/RPR FSTL
|
Professional
|
Both
|
$7,419.00
|
|
|
Service Code
|
HCPCS 43314
|
| Min. Negotiated Rate |
$1,288.00 |
| Max. Negotiated Rate |
$5,444.62 |
| Rate for Payer: Aetna Commercial |
$4,146.95
|
| Rate for Payer: Aetna Medicare |
$3,218.53
|
| Rate for Payer: BCBS Complete |
$2,079.72
|
| Rate for Payer: BCBS MAPPO |
$3,094.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,288.00
|
| Rate for Payer: BCN Commercial |
$4,525.16
|
| Rate for Payer: BCN Medicare Advantage |
$3,094.74
|
| Rate for Payer: Cash Price |
$5,935.20
|
| Rate for Payer: Cash Price |
$5,935.20
|
| Rate for Payer: Cofinity Commercial |
$4,456.43
|
| Rate for Payer: Cofinity Commercial |
$4,146.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,094.74
|
| Rate for Payer: Mclaren Medicaid |
$1,980.69
|
| Rate for Payer: Meridian Medicaid |
$2,079.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,249.48
|
| Rate for Payer: PACE SWMI |
$3,094.74
|
| Rate for Payer: PHP Medicare Advantage |
$3,094.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,980.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,193.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,444.62
|
| Rate for Payer: Priority Health Medicare |
$3,094.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,444.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,094.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,094.74
|
| Rate for Payer: UHC Medicare Advantage |
$3,187.58
|
|
|
PR ESPHGP CRV APPR W/O RPR TRACHEOESOPHGL FSTL
|
Professional
|
Both
|
$2,031.00
|
|
|
Service Code
|
HCPCS 43300
|
| Min. Negotiated Rate |
$403.64 |
| Max. Negotiated Rate |
$1,573.28 |
| Rate for Payer: Aetna Commercial |
$826.14
|
| Rate for Payer: Aetna Medicare |
$641.18
|
| Rate for Payer: BCBS Complete |
$423.82
|
| Rate for Payer: BCBS MAPPO |
$616.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,573.28
|
| Rate for Payer: BCN Commercial |
$919.69
|
| Rate for Payer: BCN Medicare Advantage |
$616.52
|
| Rate for Payer: Cash Price |
$1,624.80
|
| Rate for Payer: Cash Price |
$1,624.80
|
| Rate for Payer: Cofinity Commercial |
$887.79
|
| Rate for Payer: Cofinity Commercial |
$826.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$616.52
|
| Rate for Payer: Mclaren Medicaid |
$403.64
|
| Rate for Payer: Meridian Medicaid |
$423.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$647.35
|
| Rate for Payer: PACE SWMI |
$616.52
|
| Rate for Payer: PHP Medicare Advantage |
$616.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$403.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,421.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,106.57
|
| Rate for Payer: Priority Health Medicare |
$616.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,106.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$616.52
|
| Rate for Payer: UHC Medicare Advantage |
$635.02
|
|
|
PR ESPHGP THRC APPR W/O RPR TRACHEOESOPHGL FSTL
|
Professional
|
Both
|
$4,879.00
|
|
|
Service Code
|
HCPCS 43310
|
| Min. Negotiated Rate |
$934.86 |
| Max. Negotiated Rate |
$3,415.30 |
| Rate for Payer: Aetna Commercial |
$1,961.32
|
| Rate for Payer: Aetna Medicare |
$1,522.22
|
| Rate for Payer: BCBS Complete |
$981.60
|
| Rate for Payer: BCBS MAPPO |
$1,463.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,024.37
|
| Rate for Payer: BCN Commercial |
$2,135.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,463.67
|
| Rate for Payer: Cash Price |
$3,903.20
|
| Rate for Payer: Cash Price |
$3,903.20
|
| Rate for Payer: Cofinity Commercial |
$2,107.68
|
| Rate for Payer: Cofinity Commercial |
$1,961.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,463.67
|
| Rate for Payer: Mclaren Medicaid |
$934.86
|
| Rate for Payer: Meridian Medicaid |
$981.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,536.85
|
| Rate for Payer: PACE SWMI |
$1,463.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,463.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$934.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,415.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,569.44
|
| Rate for Payer: Priority Health Medicare |
$1,463.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,569.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,463.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,463.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,507.58
|
|
|
PR ESPHGP THRC APPR W/RPR TRACHEOESOPHGL FSTL
|
Professional
|
Both
|
$3,288.00
|
|
|
Service Code
|
HCPCS 43312
|
| Min. Negotiated Rate |
$998.12 |
| Max. Negotiated Rate |
$2,744.65 |
| Rate for Payer: Aetna Commercial |
$2,101.99
|
| Rate for Payer: Aetna Medicare |
$1,631.40
|
| Rate for Payer: BCBS Complete |
$1,048.03
|
| Rate for Payer: BCBS MAPPO |
$1,568.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,130.03
|
| Rate for Payer: BCN Commercial |
$2,281.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.65
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$2,258.86
|
| Rate for Payer: Cofinity Commercial |
$2,101.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.65
|
| Rate for Payer: Mclaren Medicaid |
$998.12
|
| Rate for Payer: Meridian Medicaid |
$1,048.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,647.08
|
| Rate for Payer: PACE SWMI |
$1,568.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$998.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,301.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,744.65
|
| Rate for Payer: Priority Health Medicare |
$1,568.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,744.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,568.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,615.71
|
|
|
PR ESRD RELATED SVC <FULL MONTH 20/>YR OLD
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 90970
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$77.13 |
| Rate for Payer: Aetna Commercial |
$12.38
|
| Rate for Payer: Aetna Medicare |
$9.61
|
| Rate for Payer: BCBS Complete |
$6.26
|
| Rate for Payer: BCBS MAPPO |
$9.24
|
| Rate for Payer: BCBS Trust/PPO |
$77.13
|
| Rate for Payer: BCN Commercial |
$13.68
|
| Rate for Payer: BCN Medicare Advantage |
$9.24
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$12.38
|
| Rate for Payer: Cofinity Commercial |
$13.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.24
|
| Rate for Payer: Mclaren Medicaid |
$5.96
|
| Rate for Payer: Meridian Medicaid |
$6.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.70
|
| Rate for Payer: PACE SWMI |
$9.24
|
| Rate for Payer: PHP Medicare Advantage |
$9.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.58
|
| Rate for Payer: Priority Health Medicare |
$9.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.24
|
| Rate for Payer: UHC Medicare Advantage |
$9.52
|
|
|
PR ESRD RELATED SVC MONTHLY 20&/>YR OLD 1 VISIT
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 90962
|
| Min. Negotiated Rate |
$128.23 |
| Max. Negotiated Rate |
$291.25 |
| Rate for Payer: Aetna Commercial |
$262.63
|
| Rate for Payer: Aetna Medicare |
$203.83
|
| Rate for Payer: BCBS Complete |
$134.64
|
| Rate for Payer: BCBS MAPPO |
$195.99
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: BCN Commercial |
$291.25
|
| Rate for Payer: BCN Medicare Advantage |
$195.99
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$282.23
|
| Rate for Payer: Cofinity Commercial |
$262.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.99
|
| Rate for Payer: Mclaren Medicaid |
$128.23
|
| Rate for Payer: Meridian Medicaid |
$134.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$205.79
|
| Rate for Payer: PACE SWMI |
$195.99
|
| Rate for Payer: PHP Medicare Advantage |
$195.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$267.69
|
| Rate for Payer: Priority Health Medicare |
$195.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$267.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$195.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$195.99
|
| Rate for Payer: UHC Medicare Advantage |
$201.87
|
|
|
PR ESRD RELATED SVC MONTHLY 20/>YR OLD 2/3 VISITS
|
Professional
|
Both
|
$406.00
|
|
|
Service Code
|
HCPCS 90961
|
| Min. Negotiated Rate |
$103.02 |
| Max. Negotiated Rate |
$423.20 |
| Rate for Payer: Aetna Commercial |
$383.09
|
| Rate for Payer: Aetna Medicare |
$297.33
|
| Rate for Payer: BCBS Complete |
$195.03
|
| Rate for Payer: BCBS MAPPO |
$285.89
|
| Rate for Payer: BCBS Trust/PPO |
$103.02
|
| Rate for Payer: BCN Commercial |
$423.20
|
| Rate for Payer: BCN Medicare Advantage |
$285.89
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cofinity Commercial |
$411.68
|
| Rate for Payer: Cofinity Commercial |
$383.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.89
|
| Rate for Payer: Mclaren Medicaid |
$185.74
|
| Rate for Payer: Meridian Medicaid |
$195.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$300.18
|
| Rate for Payer: PACE SWMI |
$285.89
|
| Rate for Payer: PHP Medicare Advantage |
$285.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$388.95
|
| Rate for Payer: Priority Health Medicare |
$285.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$388.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.89
|
| Rate for Payer: UHC Medicare Advantage |
$294.47
|
|
|
PR ESRD RELATED SVC MONTHLY 20&/> YR OLD 4/> VISITS
|
Professional
|
Both
|
$482.00
|
|
|
Service Code
|
HCPCS 90960
|
| Min. Negotiated Rate |
$223.65 |
| Max. Negotiated Rate |
$508.71 |
| Rate for Payer: Aetna Commercial |
$460.99
|
| Rate for Payer: Aetna Medicare |
$357.78
|
| Rate for Payer: BCBS Complete |
$234.83
|
| Rate for Payer: BCBS MAPPO |
$344.02
|
| Rate for Payer: BCBS Trust/PPO |
$226.11
|
| Rate for Payer: BCN Commercial |
$508.71
|
| Rate for Payer: BCN Medicare Advantage |
$344.02
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cofinity Commercial |
$495.39
|
| Rate for Payer: Cofinity Commercial |
$460.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$344.02
|
| Rate for Payer: Mclaren Medicaid |
$223.65
|
| Rate for Payer: Meridian Medicaid |
$234.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$361.22
|
| Rate for Payer: PACE SWMI |
$344.02
|
| Rate for Payer: PHP Medicare Advantage |
$344.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$337.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$467.56
|
| Rate for Payer: Priority Health Medicare |
$344.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$467.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$344.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$344.02
|
| Rate for Payer: UHC Medicare Advantage |
$354.34
|
|
|
PR ESRD SVC HOME DIALYSIS FULL MONTH 20 YR OLD
|
Professional
|
Both
|
$417.00
|
|
|
Service Code
|
HCPCS 90966
|
| Min. Negotiated Rate |
$185.74 |
| Max. Negotiated Rate |
$422.71 |
| Rate for Payer: Aetna Commercial |
$382.69
|
| Rate for Payer: Aetna Medicare |
$297.01
|
| Rate for Payer: BCBS Complete |
$195.03
|
| Rate for Payer: BCBS MAPPO |
$285.59
|
| Rate for Payer: BCBS Trust/PPO |
$211.32
|
| Rate for Payer: BCN Commercial |
$422.71
|
| Rate for Payer: BCN Medicare Advantage |
$285.59
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cash Price |
$333.60
|
| Rate for Payer: Cofinity Commercial |
$411.25
|
| Rate for Payer: Cofinity Commercial |
$382.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.59
|
| Rate for Payer: Mclaren Medicaid |
$185.74
|
| Rate for Payer: Meridian Medicaid |
$195.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.87
|
| Rate for Payer: PACE SWMI |
$285.59
|
| Rate for Payer: PHP Medicare Advantage |
$285.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$388.50
|
| Rate for Payer: Priority Health Medicare |
$285.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$388.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.59
|
| Rate for Payer: UHC Medicare Advantage |
$294.16
|
|
|
PR ESW BY PHYS W/ANES INVG LAT HUMERL EPICONDYLE
|
Professional
|
Both
|
$2,603.00
|
|
|
Service Code
|
HCPCS 0102T
|
| Min. Negotiated Rate |
$132.14 |
| Max. Negotiated Rate |
$2,753.41 |
| Rate for Payer: Aetna Commercial |
$391.44
|
| Rate for Payer: BCBS Complete |
$1,041.20
|
| Rate for Payer: BCBS Trust/PPO |
$132.14
|
| Rate for Payer: BCN Commercial |
$2,753.41
|
| Rate for Payer: Cash Price |
$2,082.40
|
| Rate for Payer: Cash Price |
$2,082.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,822.10
|
|
|
PR ETHMOIDECTOMY INTRANASAL ANTERIOR
|
Professional
|
Both
|
$2,500.00
|
|
|
Service Code
|
HCPCS 31200
|
| Min. Negotiated Rate |
$402.57 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna Commercial |
$803.02
|
| Rate for Payer: Aetna Medicare |
$623.24
|
| Rate for Payer: BCBS Complete |
$422.70
|
| Rate for Payer: BCBS MAPPO |
$599.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.94
|
| Rate for Payer: BCN Commercial |
$920.18
|
| Rate for Payer: BCN Medicare Advantage |
$599.27
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cofinity Commercial |
$862.95
|
| Rate for Payer: Cofinity Commercial |
$803.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.27
|
| Rate for Payer: Mclaren Medicaid |
$402.57
|
| Rate for Payer: Meridian Medicaid |
$422.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$629.23
|
| Rate for Payer: PACE SWMI |
$599.27
|
| Rate for Payer: PHP Medicare Advantage |
$599.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$402.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,750.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$871.92
|
| Rate for Payer: Priority Health Medicare |
$599.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$871.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$599.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.27
|
| Rate for Payer: UHC Medicare Advantage |
$617.25
|
|
|
PR ETHMOIDECTOMY INTRANASAL TOTAL
|
Professional
|
Both
|
$1,504.00
|
|
|
Service Code
|
HCPCS 31201
|
| Min. Negotiated Rate |
$501.62 |
| Max. Negotiated Rate |
$1,178.69 |
| Rate for Payer: Aetna Commercial |
$1,042.20
|
| Rate for Payer: Aetna Medicare |
$808.87
|
| Rate for Payer: BCBS Complete |
$526.70
|
| Rate for Payer: BCBS MAPPO |
$777.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,073.51
|
| Rate for Payer: BCN Commercial |
$1,178.69
|
| Rate for Payer: BCN Medicare Advantage |
$777.76
|
| Rate for Payer: Cash Price |
$1,203.20
|
| Rate for Payer: Cash Price |
$1,203.20
|
| Rate for Payer: Cofinity Commercial |
$1,042.20
|
| Rate for Payer: Cofinity Commercial |
$1,119.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$777.76
|
| Rate for Payer: Mclaren Medicaid |
$501.62
|
| Rate for Payer: Meridian Medicaid |
$526.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$816.65
|
| Rate for Payer: PACE SWMI |
$777.76
|
| Rate for Payer: PHP Medicare Advantage |
$777.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$501.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,052.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,116.87
|
| Rate for Payer: Priority Health Medicare |
$777.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,116.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$777.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$777.76
|
| Rate for Payer: UHC Medicare Advantage |
$801.09
|
|
|
PR EVACUATION SUBUNGUAL HEMATOMA
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 11740
|
| Min. Negotiated Rate |
$20.66 |
| Max. Negotiated Rate |
$116.11 |
| Rate for Payer: Aetna Commercial |
$41.10
|
| Rate for Payer: Aetna Medicare |
$31.90
|
| Rate for Payer: BCBS Complete |
$21.69
|
| Rate for Payer: BCBS MAPPO |
$30.67
|
| Rate for Payer: BCBS Trust/PPO |
$116.11
|
| Rate for Payer: BCN Commercial |
$67.15
|
| Rate for Payer: BCN Medicare Advantage |
$30.67
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$44.16
|
| Rate for Payer: Cofinity Commercial |
$41.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.67
|
| Rate for Payer: Mclaren Medicaid |
$20.66
|
| Rate for Payer: Meridian Medicaid |
$21.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.20
|
| Rate for Payer: PACE SWMI |
$30.67
|
| Rate for Payer: PHP Medicare Advantage |
$30.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.05
|
| Rate for Payer: Priority Health Medicare |
$30.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.67
|
| Rate for Payer: UHC Medicare Advantage |
$31.59
|
|
|
PR EVAL CENTRAL AUDITORY FUNCJ W/REPRT 1ST 60 MIN
|
Professional
|
Both
|
$165.00
|
|
|
Service Code
|
HCPCS 92620
|
| Min. Negotiated Rate |
$66.00 |
| Max. Negotiated Rate |
$295.85 |
| Rate for Payer: Aetna Commercial |
$103.73
|
| Rate for Payer: Aetna Medicare |
$80.51
|
| Rate for Payer: BCBS Complete |
$66.00
|
| Rate for Payer: BCBS MAPPO |
$77.41
|
| Rate for Payer: BCBS Trust/PPO |
$295.85
|
| Rate for Payer: BCN Commercial |
$129.01
|
| Rate for Payer: BCN Medicare Advantage |
$77.41
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cofinity Commercial |
$103.73
|
| Rate for Payer: Cofinity Commercial |
$111.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$81.28
|
| Rate for Payer: PACE SWMI |
$77.41
|
| Rate for Payer: PHP Medicare Advantage |
$77.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.54
|
| Rate for Payer: Priority Health Medicare |
$77.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$77.41
|
| Rate for Payer: UHC Medicare Advantage |
$79.73
|
|
|
PR EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 92621
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$281.58 |
| Rate for Payer: Aetna Commercial |
$24.24
|
| Rate for Payer: Aetna Medicare |
$18.81
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$18.09
|
| Rate for Payer: BCBS Trust/PPO |
$281.58
|
| Rate for Payer: BCN Commercial |
$31.76
|
| Rate for Payer: BCN Medicare Advantage |
$18.09
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$24.24
|
| Rate for Payer: Cofinity Commercial |
$26.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.99
|
| Rate for Payer: PACE SWMI |
$18.09
|
| Rate for Payer: PHP Medicare Advantage |
$18.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.71
|
| Rate for Payer: Priority Health Medicare |
$18.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.09
|
| Rate for Payer: UHC Medicare Advantage |
$18.63
|
|
|
PR EVAL OF ORTHOTIC/PROSTH USE, EA 15 MIN
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 97762
|
| Min. Negotiated Rate |
$29.60 |
| Max. Negotiated Rate |
$51.80 |
| Rate for Payer: BCBS Complete |
$29.60
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.80
|
|
