|
PR FTH/GFT FR W/DIR CLSR S/A/L EA ADDL 20 CM/<
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS 15221
|
| Min. Negotiated Rate |
$43.67 |
| Max. Negotiated Rate |
$194.60 |
| Rate for Payer: Aetna Commercial |
$90.69
|
| Rate for Payer: Aetna Medicare |
$70.39
|
| Rate for Payer: BCBS Complete |
$45.85
|
| Rate for Payer: BCBS MAPPO |
$67.68
|
| Rate for Payer: BCBS Trust/PPO |
$150.00
|
| Rate for Payer: BCN Commercial |
$190.59
|
| Rate for Payer: BCN Medicare Advantage |
$67.68
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$97.46
|
| Rate for Payer: Cofinity Commercial |
$90.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.68
|
| Rate for Payer: Mclaren Medicaid |
$43.67
|
| Rate for Payer: Meridian Medicaid |
$45.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$71.06
|
| Rate for Payer: PACE SWMI |
$67.68
|
| Rate for Payer: PHP Medicare Advantage |
$67.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.85
|
| Rate for Payer: Priority Health Medicare |
$67.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.68
|
| Rate for Payer: UHC Medicare Advantage |
$69.71
|
|
|
PR FTH/GT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F EA20CM/<
|
Professional
|
Both
|
$348.00
|
|
|
Service Code
|
HCPCS 15241
|
| Min. Negotiated Rate |
$67.73 |
| Max. Negotiated Rate |
$2,189.70 |
| Rate for Payer: Aetna Commercial |
$138.76
|
| Rate for Payer: Aetna Medicare |
$107.69
|
| Rate for Payer: BCBS Complete |
$71.12
|
| Rate for Payer: BCBS MAPPO |
$103.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.70
|
| Rate for Payer: BCN Commercial |
$253.63
|
| Rate for Payer: BCN Medicare Advantage |
$103.55
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cofinity Commercial |
$149.11
|
| Rate for Payer: Cofinity Commercial |
$138.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.55
|
| Rate for Payer: Mclaren Medicaid |
$67.73
|
| Rate for Payer: Meridian Medicaid |
$71.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$108.73
|
| Rate for Payer: PACE SWMI |
$103.55
|
| Rate for Payer: PHP Medicare Advantage |
$103.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.25
|
| Rate for Payer: Priority Health Medicare |
$103.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.55
|
| Rate for Payer: UHC Medicare Advantage |
$106.66
|
|
|
PR FT INSERT UCB BERKELEY SHELL
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS L3000
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$324.23 |
| Rate for Payer: Aetna Commercial |
$189.20
|
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: BCN Commercial |
$324.23
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
|
|
PR FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR
|
Professional
|
Both
|
$504.00
|
|
|
Service Code
|
HCPCS 95961
|
| Min. Negotiated Rate |
$173.28 |
| Max. Negotiated Rate |
$455.45 |
| Rate for Payer: Aetna Commercial |
$399.87
|
| Rate for Payer: Aetna Medicare |
$310.35
|
| Rate for Payer: BCBS Complete |
$201.60
|
| Rate for Payer: BCBS MAPPO |
$298.41
|
| Rate for Payer: BCBS Trust/PPO |
$173.28
|
| Rate for Payer: BCN Commercial |
$455.45
|
| Rate for Payer: BCN Medicare Advantage |
$298.41
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: Cofinity Commercial |
$429.71
|
| Rate for Payer: Cofinity Commercial |
$399.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$313.33
|
| Rate for Payer: PACE SWMI |
$298.41
|
| Rate for Payer: PHP Medicare Advantage |
$298.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$418.60
|
| Rate for Payer: Priority Health Medicare |
$298.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$418.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.41
|
| Rate for Payer: UHC Medicare Advantage |
$307.36
|
|
|
PR FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 92250
|
| Min. Negotiated Rate |
$35.59 |
| Max. Negotiated Rate |
$1,952.60 |
| Rate for Payer: Aetna Commercial |
$47.69
|
| Rate for Payer: Aetna Medicare |
$37.01
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS MAPPO |
$35.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,952.60
|
| Rate for Payer: BCN Commercial |
$54.24
|
| Rate for Payer: BCN Medicare Advantage |
$35.59
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$51.25
|
| Rate for Payer: Cofinity Commercial |
$47.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.37
|
| Rate for Payer: PACE SWMI |
$35.59
|
| Rate for Payer: PHP Medicare Advantage |
$35.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.56
|
| Rate for Payer: Priority Health Medicare |
$35.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.59
|
| Rate for Payer: UHC Medicare Advantage |
$36.66
|
|
|
PR F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY
|
Professional
|
Both
|
$321.00
|
|
|
Service Code
|
HCPCS 93304
|
| Min. Negotiated Rate |
$128.40 |
| Max. Negotiated Rate |
$799.32 |
| Rate for Payer: Aetna Commercial |
$195.84
|
| Rate for Payer: Aetna Medicare |
$152.00
|
| Rate for Payer: BCBS Complete |
$128.40
|
| Rate for Payer: BCBS MAPPO |
$146.15
|
| Rate for Payer: BCBS Trust/PPO |
$799.32
|
| Rate for Payer: BCN Commercial |
$227.24
|
| Rate for Payer: BCN Medicare Advantage |
$146.15
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cash Price |
$256.80
|
| Rate for Payer: Cofinity Commercial |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$210.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$153.46
|
| Rate for Payer: PACE SWMI |
$146.15
|
| Rate for Payer: PHP Medicare Advantage |
$146.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$219.89
|
| Rate for Payer: Priority Health Medicare |
$146.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.15
|
| Rate for Payer: UHC Medicare Advantage |
$150.53
|
|
|
PR FUROSEMIDE INJECTION
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS J1940
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$2.80 |
| Rate for Payer: Aetna Commercial |
$0.66
|
| Rate for Payer: Aetna Medicare |
$0.51
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: BCBS MAPPO |
$0.50
|
| Rate for Payer: BCBS Trust/PPO |
$0.13
|
| Rate for Payer: BCN Commercial |
$0.13
|
| Rate for Payer: BCN Medicare Advantage |
$0.50
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cofinity Commercial |
$0.71
|
| Rate for Payer: Cofinity Commercial |
$0.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.52
|
| Rate for Payer: PACE SWMI |
$0.50
|
| Rate for Payer: PHP Medicare Advantage |
$0.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.80
|
| Rate for Payer: Priority Health Medicare |
$0.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.50
|
| Rate for Payer: UHC Medicare Advantage |
$0.51
|
|
|
PR GARAMYCIN GENTAMICIN INJ
|
Professional
|
Both
|
$4.00
|
|
|
Service Code
|
HCPCS J1580
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$4.31 |
| Rate for Payer: Aetna Commercial |
$4.01
|
| Rate for Payer: Aetna Medicare |
$3.11
|
| Rate for Payer: BCBS Complete |
$1.60
|
| Rate for Payer: BCBS MAPPO |
$2.99
|
| Rate for Payer: BCBS Trust/PPO |
$0.88
|
| Rate for Payer: BCN Commercial |
$0.68
|
| Rate for Payer: BCN Medicare Advantage |
$2.99
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cash Price |
$3.20
|
| Rate for Payer: Cofinity Commercial |
$4.31
|
| Rate for Payer: Cofinity Commercial |
$4.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.14
|
| Rate for Payer: PACE SWMI |
$2.99
|
| Rate for Payer: PHP Medicare Advantage |
$2.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.80
|
| Rate for Payer: Priority Health Medicare |
$2.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.99
|
| Rate for Payer: UHC Medicare Advantage |
$3.08
|
|
|
PR GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 94727
|
| Min. Negotiated Rate |
$41.03 |
| Max. Negotiated Rate |
$251.47 |
| Rate for Payer: Aetna Commercial |
$54.98
|
| Rate for Payer: Aetna Medicare |
$42.67
|
| Rate for Payer: BCBS Complete |
$48.40
|
| Rate for Payer: BCBS MAPPO |
$41.03
|
| Rate for Payer: BCBS Trust/PPO |
$251.47
|
| Rate for Payer: BCN Commercial |
$63.53
|
| Rate for Payer: BCN Medicare Advantage |
$41.03
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cofinity Commercial |
$59.08
|
| Rate for Payer: Cofinity Commercial |
$54.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.08
|
| Rate for Payer: PACE SWMI |
$41.03
|
| Rate for Payer: PHP Medicare Advantage |
$41.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.38
|
| Rate for Payer: Priority Health Medicare |
$41.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.03
|
| Rate for Payer: UHC Medicare Advantage |
$42.26
|
|
|
PR GASTRIC INTUBATJ & ASPIRAJ W/PHYS SKILL/LAVAGE
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 43753
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$192.83 |
| Rate for Payer: Aetna Commercial |
$28.89
|
| Rate for Payer: Aetna Medicare |
$22.42
|
| Rate for Payer: BCBS Complete |
$14.31
|
| Rate for Payer: BCBS MAPPO |
$21.56
|
| Rate for Payer: BCBS Trust/PPO |
$192.83
|
| Rate for Payer: BCN Commercial |
$31.27
|
| Rate for Payer: BCN Medicare Advantage |
$21.56
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$31.05
|
| Rate for Payer: Cofinity Commercial |
$28.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.56
|
| Rate for Payer: Mclaren Medicaid |
$13.63
|
| Rate for Payer: Meridian Medicaid |
$14.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.64
|
| Rate for Payer: PACE SWMI |
$21.56
|
| Rate for Payer: PHP Medicare Advantage |
$21.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.63
|
| Rate for Payer: Priority Health Medicare |
$21.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.56
|
| Rate for Payer: UHC Medicare Advantage |
$22.21
|
|
|
PR GASTROCNEMIUS RECESSION
|
Professional
|
Both
|
$1,488.00
|
|
|
Service Code
|
HCPCS 27687
|
| Min. Negotiated Rate |
$294.15 |
| Max. Negotiated Rate |
$2,402.71 |
| Rate for Payer: Aetna Commercial |
$596.57
|
| Rate for Payer: Aetna Medicare |
$463.01
|
| Rate for Payer: BCBS Complete |
$308.86
|
| Rate for Payer: BCBS MAPPO |
$445.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,402.71
|
| Rate for Payer: BCN Commercial |
$666.06
|
| Rate for Payer: BCN Medicare Advantage |
$445.20
|
| Rate for Payer: Cash Price |
$1,190.40
|
| Rate for Payer: Cash Price |
$1,190.40
|
| Rate for Payer: Cofinity Commercial |
$596.57
|
| Rate for Payer: Cofinity Commercial |
$641.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.20
|
| Rate for Payer: Mclaren Medicaid |
$294.15
|
| Rate for Payer: Meridian Medicaid |
$308.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$467.46
|
| Rate for Payer: PACE SWMI |
$445.20
|
| Rate for Payer: PHP Medicare Advantage |
$445.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$294.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,041.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.01
|
| Rate for Payer: Priority Health Medicare |
$445.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$696.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$445.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$445.20
|
| Rate for Payer: UHC Medicare Advantage |
$458.56
|
|
|
PR GASTRODUODENOSTOMY
|
Professional
|
Both
|
$2,437.00
|
|
|
Service Code
|
HCPCS 43810
|
| Min. Negotiated Rate |
$486.56 |
| Max. Negotiated Rate |
$1,786.85 |
| Rate for Payer: Aetna Commercial |
$1,356.99
|
| Rate for Payer: Aetna Medicare |
$1,053.19
|
| Rate for Payer: BCBS Complete |
$683.48
|
| Rate for Payer: BCBS MAPPO |
$1,012.68
|
| Rate for Payer: BCBS Trust/PPO |
$486.56
|
| Rate for Payer: BCN Commercial |
$1,485.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,012.68
|
| Rate for Payer: Cash Price |
$1,949.60
|
| Rate for Payer: Cash Price |
$1,949.60
|
| Rate for Payer: Cofinity Commercial |
$1,356.99
|
| Rate for Payer: Cofinity Commercial |
$1,458.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,012.68
|
| Rate for Payer: Mclaren Medicaid |
$650.93
|
| Rate for Payer: Meridian Medicaid |
$683.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,063.31
|
| Rate for Payer: PACE SWMI |
$1,012.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,012.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$650.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,705.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,786.85
|
| Rate for Payer: Priority Health Medicare |
$1,012.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,786.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,012.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,012.68
|
| Rate for Payer: UHC Medicare Advantage |
$1,043.06
|
|
|
PR GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT
|
Professional
|
Both
|
$336.00
|
|
|
Service Code
|
HCPCS 91034
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$1,518.86 |
| Rate for Payer: Aetna Commercial |
$243.21
|
| Rate for Payer: Aetna Commercial |
$243.21
|
| Rate for Payer: Aetna Medicare |
$188.76
|
| Rate for Payer: Aetna Medicare |
$188.76
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS Complete |
$134.40
|
| Rate for Payer: BCBS MAPPO |
$181.50
|
| Rate for Payer: BCBS MAPPO |
$181.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,518.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,518.86
|
| Rate for Payer: BCN Commercial |
$281.97
|
| Rate for Payer: BCN Commercial |
$281.97
|
| Rate for Payer: BCN Medicare Advantage |
$181.50
|
| Rate for Payer: BCN Medicare Advantage |
$181.50
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$243.21
|
| Rate for Payer: Cofinity Commercial |
$261.36
|
| Rate for Payer: Cofinity Commercial |
$243.21
|
| Rate for Payer: Cofinity Commercial |
$261.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$190.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$190.58
|
| Rate for Payer: PACE SWMI |
$181.50
|
| Rate for Payer: PACE SWMI |
$181.50
|
| Rate for Payer: PHP Medicare Advantage |
$181.50
|
| Rate for Payer: PHP Medicare Advantage |
$181.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$259.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$259.16
|
| Rate for Payer: Priority Health Medicare |
$181.50
|
| Rate for Payer: Priority Health Medicare |
$181.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$259.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$259.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$181.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$181.50
|
| Rate for Payer: UHC Medicare Advantage |
$186.94
|
| Rate for Payer: UHC Medicare Advantage |
$186.94
|
|
|
PR GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 91037
|
| Min. Negotiated Rate |
$38.00 |
| Max. Negotiated Rate |
$963.09 |
| Rate for Payer: Aetna Commercial |
$213.27
|
| Rate for Payer: Aetna Commercial |
$213.27
|
| Rate for Payer: Aetna Medicare |
$165.53
|
| Rate for Payer: Aetna Medicare |
$165.53
|
| Rate for Payer: BCBS Complete |
$38.00
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: BCBS MAPPO |
$159.16
|
| Rate for Payer: BCBS MAPPO |
$159.16
|
| Rate for Payer: BCBS Trust/PPO |
$963.09
|
| Rate for Payer: BCBS Trust/PPO |
$963.09
|
| Rate for Payer: BCN Commercial |
$246.78
|
| Rate for Payer: BCN Commercial |
$246.78
|
| Rate for Payer: BCN Medicare Advantage |
$159.16
|
| Rate for Payer: BCN Medicare Advantage |
$159.16
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$229.19
|
| Rate for Payer: Cofinity Commercial |
$213.27
|
| Rate for Payer: Cofinity Commercial |
$213.27
|
| Rate for Payer: Cofinity Commercial |
$229.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$167.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$167.12
|
| Rate for Payer: PACE SWMI |
$159.16
|
| Rate for Payer: PACE SWMI |
$159.16
|
| Rate for Payer: PHP Medicare Advantage |
$159.16
|
| Rate for Payer: PHP Medicare Advantage |
$159.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.82
|
| Rate for Payer: Priority Health Medicare |
$159.16
|
| Rate for Payer: Priority Health Medicare |
$159.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.16
|
| Rate for Payer: UHC Medicare Advantage |
$163.93
|
| Rate for Payer: UHC Medicare Advantage |
$163.93
|
|
|
PR GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 91035
|
| Min. Negotiated Rate |
$66.40 |
| Max. Negotiated Rate |
$976.30 |
| Rate for Payer: Aetna Commercial |
$580.76
|
| Rate for Payer: Aetna Commercial |
$580.76
|
| Rate for Payer: Aetna Medicare |
$450.74
|
| Rate for Payer: Aetna Medicare |
$450.74
|
| Rate for Payer: BCBS Complete |
$343.20
|
| Rate for Payer: BCBS Complete |
$66.40
|
| Rate for Payer: BCBS MAPPO |
$433.40
|
| Rate for Payer: BCBS MAPPO |
$433.40
|
| Rate for Payer: BCBS Trust/PPO |
$976.30
|
| Rate for Payer: BCBS Trust/PPO |
$976.30
|
| Rate for Payer: BCN Commercial |
$677.30
|
| Rate for Payer: BCN Commercial |
$677.30
|
| Rate for Payer: BCN Medicare Advantage |
$433.40
|
| Rate for Payer: BCN Medicare Advantage |
$433.40
|
| Rate for Payer: Cash Price |
$686.40
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$686.40
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cofinity Commercial |
$624.10
|
| Rate for Payer: Cofinity Commercial |
$624.10
|
| Rate for Payer: Cofinity Commercial |
$580.76
|
| Rate for Payer: Cofinity Commercial |
$580.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$455.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$455.07
|
| Rate for Payer: PACE SWMI |
$433.40
|
| Rate for Payer: PACE SWMI |
$433.40
|
| Rate for Payer: PHP Medicare Advantage |
$433.40
|
| Rate for Payer: PHP Medicare Advantage |
$433.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$622.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$622.52
|
| Rate for Payer: Priority Health Medicare |
$433.40
|
| Rate for Payer: Priority Health Medicare |
$433.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$622.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$622.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.40
|
| Rate for Payer: UHC Medicare Advantage |
$446.40
|
| Rate for Payer: UHC Medicare Advantage |
$446.40
|
|
|
PR GASTROJEJUNOSTOMY W/O VAGOTOMY
|
Professional
|
Both
|
$2,570.00
|
|
|
Service Code
|
HCPCS 43820
|
| Min. Negotiated Rate |
$860.09 |
| Max. Negotiated Rate |
$2,359.53 |
| Rate for Payer: Aetna Commercial |
$1,791.81
|
| Rate for Payer: Aetna Medicare |
$1,390.66
|
| Rate for Payer: BCBS Complete |
$903.09
|
| Rate for Payer: BCBS MAPPO |
$1,337.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,050.26
|
| Rate for Payer: BCN Commercial |
$1,961.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,337.17
|
| Rate for Payer: Cash Price |
$2,056.00
|
| Rate for Payer: Cash Price |
$2,056.00
|
| Rate for Payer: Cofinity Commercial |
$1,791.81
|
| Rate for Payer: Cofinity Commercial |
$1,925.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,337.17
|
| Rate for Payer: Mclaren Medicaid |
$860.09
|
| Rate for Payer: Meridian Medicaid |
$903.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,404.03
|
| Rate for Payer: PACE SWMI |
$1,337.17
|
| Rate for Payer: PHP Medicare Advantage |
$1,337.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,799.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,359.53
|
| Rate for Payer: Priority Health Medicare |
$1,337.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,359.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,337.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,337.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,377.29
|
|
|
PR GASTROJEJUNOSTOMY W/VAGOTOMY ANY TYPE
|
Professional
|
Both
|
$2,530.00
|
|
|
Service Code
|
HCPCS 43825
|
| Min. Negotiated Rate |
$669.36 |
| Max. Negotiated Rate |
$2,304.27 |
| Rate for Payer: Aetna Commercial |
$1,750.04
|
| Rate for Payer: Aetna Medicare |
$1,358.24
|
| Rate for Payer: BCBS Complete |
$880.96
|
| Rate for Payer: BCBS MAPPO |
$1,306.00
|
| Rate for Payer: BCBS Trust/PPO |
$669.36
|
| Rate for Payer: BCN Commercial |
$1,915.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,306.00
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cash Price |
$2,024.00
|
| Rate for Payer: Cofinity Commercial |
$1,880.64
|
| Rate for Payer: Cofinity Commercial |
$1,750.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,306.00
|
| Rate for Payer: Mclaren Medicaid |
$839.01
|
| Rate for Payer: Meridian Medicaid |
$880.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,371.30
|
| Rate for Payer: PACE SWMI |
$1,306.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,306.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$839.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,771.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,304.27
|
| Rate for Payer: Priority Health Medicare |
$1,306.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,304.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,306.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,306.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,345.18
|
|
|
PR GASTRORRHAPHY SUTR PRF8 DUOL/GSTR ULCER WND/INJ
|
Professional
|
Both
|
$2,766.00
|
|
|
Service Code
|
HCPCS 43840
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$2,387.17 |
| Rate for Payer: Aetna Commercial |
$1,813.14
|
| Rate for Payer: Aetna Medicare |
$1,407.21
|
| Rate for Payer: BCBS Complete |
$912.49
|
| Rate for Payer: BCBS MAPPO |
$1,353.09
|
| Rate for Payer: BCBS Trust/PPO |
$75.56
|
| Rate for Payer: BCN Commercial |
$1,984.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,353.09
|
| Rate for Payer: Cash Price |
$2,212.80
|
| Rate for Payer: Cash Price |
$2,212.80
|
| Rate for Payer: Cofinity Commercial |
$1,948.45
|
| Rate for Payer: Cofinity Commercial |
$1,813.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,353.09
|
| Rate for Payer: Mclaren Medicaid |
$869.04
|
| Rate for Payer: Meridian Medicaid |
$912.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,420.74
|
| Rate for Payer: PACE SWMI |
$1,353.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,353.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$869.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,936.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,387.17
|
| Rate for Payer: Priority Health Medicare |
$1,353.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,387.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,353.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,353.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,393.68
|
|
|
PR GASTROSTOMY OPN NEONATAL FEEDING
|
Professional
|
Both
|
$2,090.00
|
|
|
Service Code
|
HCPCS 43831
|
| Min. Negotiated Rate |
$392.99 |
| Max. Negotiated Rate |
$1,463.00 |
| Rate for Payer: Aetna Commercial |
$808.53
|
| Rate for Payer: Aetna Medicare |
$627.52
|
| Rate for Payer: BCBS Complete |
$412.64
|
| Rate for Payer: BCBS MAPPO |
$603.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,286.41
|
| Rate for Payer: BCN Commercial |
$895.74
|
| Rate for Payer: BCN Medicare Advantage |
$603.38
|
| Rate for Payer: Cash Price |
$1,672.00
|
| Rate for Payer: Cash Price |
$1,672.00
|
| Rate for Payer: Cofinity Commercial |
$808.53
|
| Rate for Payer: Cofinity Commercial |
$868.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$603.38
|
| Rate for Payer: Mclaren Medicaid |
$392.99
|
| Rate for Payer: Meridian Medicaid |
$412.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$633.55
|
| Rate for Payer: PACE SWMI |
$603.38
|
| Rate for Payer: PHP Medicare Advantage |
$603.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,077.75
|
| Rate for Payer: Priority Health Medicare |
$603.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,077.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$603.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$603.38
|
| Rate for Payer: UHC Medicare Advantage |
$621.48
|
|
|
PR GASTROSTOMY OPN W/CONSTJ GSTR TUBE
|
Professional
|
Both
|
$2,876.00
|
|
|
Service Code
|
HCPCS 43832
|
| Min. Negotiated Rate |
$670.10 |
| Max. Negotiated Rate |
$2,013.20 |
| Rate for Payer: Aetna Commercial |
$1,390.83
|
| Rate for Payer: Aetna Medicare |
$1,079.45
|
| Rate for Payer: BCBS Complete |
$703.60
|
| Rate for Payer: BCBS MAPPO |
$1,037.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,303.84
|
| Rate for Payer: BCN Commercial |
$1,523.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,037.93
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cash Price |
$2,300.80
|
| Rate for Payer: Cofinity Commercial |
$1,494.62
|
| Rate for Payer: Cofinity Commercial |
$1,390.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,037.93
|
| Rate for Payer: Mclaren Medicaid |
$670.10
|
| Rate for Payer: Meridian Medicaid |
$703.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,089.83
|
| Rate for Payer: PACE SWMI |
$1,037.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,037.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$670.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,013.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,832.70
|
| Rate for Payer: Priority Health Medicare |
$1,037.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,832.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,037.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,037.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,069.07
|
|
|
PR GASTROSTOMY OPN W/O CONSTJ GSTR TUBE SPX
|
Professional
|
Both
|
$2,090.00
|
|
|
Service Code
|
HCPCS 43830
|
| Min. Negotiated Rate |
$281.06 |
| Max. Negotiated Rate |
$1,463.00 |
| Rate for Payer: Aetna Commercial |
$935.51
|
| Rate for Payer: Aetna Medicare |
$726.07
|
| Rate for Payer: BCBS Complete |
$473.92
|
| Rate for Payer: BCBS MAPPO |
$698.14
|
| Rate for Payer: BCBS Trust/PPO |
$281.06
|
| Rate for Payer: BCN Commercial |
$1,030.14
|
| Rate for Payer: BCN Medicare Advantage |
$698.14
|
| Rate for Payer: Cash Price |
$1,672.00
|
| Rate for Payer: Cash Price |
$1,672.00
|
| Rate for Payer: Cofinity Commercial |
$935.51
|
| Rate for Payer: Cofinity Commercial |
$1,005.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$698.14
|
| Rate for Payer: Mclaren Medicaid |
$451.35
|
| Rate for Payer: Meridian Medicaid |
$473.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$733.05
|
| Rate for Payer: PACE SWMI |
$698.14
|
| Rate for Payer: PHP Medicare Advantage |
$698.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$451.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,463.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,239.44
|
| Rate for Payer: Priority Health Medicare |
$698.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,239.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$698.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$698.14
|
| Rate for Payer: UHC Medicare Advantage |
$719.08
|
|
|
PR GASTROTOMY W/EXPLORATION/FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$2,212.00
|
|
|
Service Code
|
HCPCS 43500
|
| Min. Negotiated Rate |
$504.38 |
| Max. Negotiated Rate |
$1,939.39 |
| Rate for Payer: Aetna Commercial |
$1,043.34
|
| Rate for Payer: Aetna Medicare |
$809.75
|
| Rate for Payer: BCBS Complete |
$529.60
|
| Rate for Payer: BCBS MAPPO |
$778.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,939.39
|
| Rate for Payer: BCN Commercial |
$1,144.97
|
| Rate for Payer: BCN Medicare Advantage |
$778.61
|
| Rate for Payer: Cash Price |
$1,769.60
|
| Rate for Payer: Cash Price |
$1,769.60
|
| Rate for Payer: Cofinity Commercial |
$1,121.20
|
| Rate for Payer: Cofinity Commercial |
$1,043.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$778.61
|
| Rate for Payer: Mclaren Medicaid |
$504.38
|
| Rate for Payer: Meridian Medicaid |
$529.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$817.54
|
| Rate for Payer: PACE SWMI |
$778.61
|
| Rate for Payer: PHP Medicare Advantage |
$778.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$504.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,548.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,377.63
|
| Rate for Payer: Priority Health Medicare |
$778.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,377.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$778.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$778.61
|
| Rate for Payer: UHC Medicare Advantage |
$801.97
|
|
|
PR GASTROTOMY W/SUTURE REPAIR BLEEDING ULCER
|
Professional
|
Both
|
$3,898.00
|
|
|
Service Code
|
HCPCS 43501
|
| Min. Negotiated Rate |
$864.35 |
| Max. Negotiated Rate |
$2,728.60 |
| Rate for Payer: Aetna Commercial |
$1,795.81
|
| Rate for Payer: Aetna Medicare |
$1,393.77
|
| Rate for Payer: BCBS Complete |
$907.57
|
| Rate for Payer: BCBS MAPPO |
$1,340.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.41
|
| Rate for Payer: BCN Commercial |
$1,964.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,340.16
|
| Rate for Payer: Cash Price |
$3,118.40
|
| Rate for Payer: Cash Price |
$3,118.40
|
| Rate for Payer: Cofinity Commercial |
$1,795.81
|
| Rate for Payer: Cofinity Commercial |
$1,929.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,340.16
|
| Rate for Payer: Mclaren Medicaid |
$864.35
|
| Rate for Payer: Meridian Medicaid |
$907.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,407.17
|
| Rate for Payer: PACE SWMI |
$1,340.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,340.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$864.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,728.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,363.66
|
| Rate for Payer: Priority Health Medicare |
$1,340.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,363.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,340.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,340.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,380.36
|
|
|
PR GEL-ONE
|
Professional
|
Both
|
$1,340.00
|
|
|
Service Code
|
HCPCS J7326
|
| Min. Negotiated Rate |
$506.67 |
| Max. Negotiated Rate |
$1,159.20 |
| Rate for Payer: Aetna Commercial |
$692.41
|
| Rate for Payer: Aetna Medicare |
$537.40
|
| Rate for Payer: BCBS Complete |
$536.00
|
| Rate for Payer: BCBS MAPPO |
$516.73
|
| Rate for Payer: BCBS Trust/PPO |
$506.67
|
| Rate for Payer: BCN Commercial |
$1,159.20
|
| Rate for Payer: BCN Medicare Advantage |
$516.73
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cash Price |
$1,072.00
|
| Rate for Payer: Cofinity Commercial |
$744.09
|
| Rate for Payer: Cofinity Commercial |
$692.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$516.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$542.56
|
| Rate for Payer: PACE SWMI |
$516.73
|
| Rate for Payer: PHP Medicare Advantage |
$516.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$938.00
|
| Rate for Payer: Priority Health Medicare |
$516.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$516.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$516.73
|
| Rate for Payer: UHC Medicare Advantage |
$532.23
|
|
|
PR GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP
|
Professional
|
Both
|
$192.00
|
|
|
Service Code
|
HCPCS 91112
|
| Min. Negotiated Rate |
$76.80 |
| Max. Negotiated Rate |
$2,415.54 |
| Rate for Payer: Aetna Commercial |
$2,054.03
|
| Rate for Payer: Aetna Medicare |
$1,594.17
|
| Rate for Payer: BCBS Complete |
$76.80
|
| Rate for Payer: BCBS MAPPO |
$1,532.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,077.20
|
| Rate for Payer: BCN Commercial |
$2,415.54
|
| Rate for Payer: BCN Medicare Advantage |
$1,532.86
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cofinity Commercial |
$2,207.32
|
| Rate for Payer: Cofinity Commercial |
$2,054.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,532.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,609.50
|
| Rate for Payer: PACE SWMI |
$1,532.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,532.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,220.11
|
| Rate for Payer: Priority Health Medicare |
$1,532.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,220.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,532.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,532.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,578.85
|
|
