|
PR HARVEST UXTR VEIN 1 SGM LOWER EXTREMITY/CABG PX
|
Professional
|
Both
|
$1,105.00
|
|
|
Service Code
|
HCPCS 35500
|
| Min. Negotiated Rate |
$197.66 |
| Max. Negotiated Rate |
$777.66 |
| Rate for Payer: Aetna Commercial |
$419.88
|
| Rate for Payer: Aetna Medicare |
$325.87
|
| Rate for Payer: BCBS Complete |
$207.54
|
| Rate for Payer: BCBS MAPPO |
$313.34
|
| Rate for Payer: BCBS Trust/PPO |
$777.66
|
| Rate for Payer: BCN Commercial |
$451.54
|
| Rate for Payer: BCN Medicare Advantage |
$313.34
|
| Rate for Payer: Cash Price |
$884.00
|
| Rate for Payer: Cash Price |
$884.00
|
| Rate for Payer: Cofinity Commercial |
$419.88
|
| Rate for Payer: Cofinity Commercial |
$451.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$313.34
|
| Rate for Payer: Mclaren Medicaid |
$197.66
|
| Rate for Payer: Meridian Medicaid |
$207.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$329.01
|
| Rate for Payer: PACE SWMI |
$313.34
|
| Rate for Payer: PHP Medicare Advantage |
$313.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$197.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$773.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$491.53
|
| Rate for Payer: Priority Health Medicare |
$313.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$491.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$313.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$313.34
|
| Rate for Payer: UHC Medicare Advantage |
$322.74
|
|
|
PR HBOT, FULL BODY CHAMBER, 30M
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS G0277
|
| Min. Negotiated Rate |
$63.20 |
| Max. Negotiated Rate |
$784.00 |
| Rate for Payer: Aetna Commercial |
$210.30
|
| Rate for Payer: Aetna Medicare |
$163.22
|
| Rate for Payer: BCBS Complete |
$63.20
|
| Rate for Payer: BCBS MAPPO |
$156.94
|
| Rate for Payer: BCBS Trust/PPO |
$784.00
|
| Rate for Payer: BCN Commercial |
$248.25
|
| Rate for Payer: BCN Medicare Advantage |
$156.94
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$225.99
|
| Rate for Payer: Cofinity Commercial |
$210.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$164.79
|
| Rate for Payer: PACE SWMI |
$156.94
|
| Rate for Payer: PHP Medicare Advantage |
$156.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.17
|
| Rate for Payer: Priority Health Medicare |
$156.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.94
|
| Rate for Payer: UHC Medicare Advantage |
$161.65
|
|
|
PR HEAL & BEHAV ASSESS,EA 15 MIN,INIT
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS 96150
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$28.70 |
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.70
|
|
|
PR HEAL & BEHAV ASSESS,EA 15 MIN,RE-ASSESS
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 96151
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$28.00 |
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.00
|
|
|
PR HEAL & BEHAV INTERV,EA 15 MIN,FAM W/O PT
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 96155
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$26.60 |
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.60
|
|
|
PR HEAL & BEHAV INTERV,EA 15 MIN,FAM W/PT
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS 96154
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$25.90 |
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.90
|
|
|
PR HEAL & BEHAV INTERVENT,EA 15 MIN,INDIV
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 96152
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$26.60 |
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.60
|
|
|
PR HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 96156
|
| Min. Negotiated Rate |
$56.02 |
| Max. Negotiated Rate |
$137.32 |
| Rate for Payer: Aetna Commercial |
$111.94
|
| Rate for Payer: Aetna Medicare |
$86.88
|
| Rate for Payer: BCBS Complete |
$58.82
|
| Rate for Payer: BCBS MAPPO |
$83.54
|
| Rate for Payer: BCBS Trust/PPO |
$135.77
|
| Rate for Payer: BCN Commercial |
$137.32
|
| Rate for Payer: BCN Medicare Advantage |
$83.54
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$111.94
|
| Rate for Payer: Cofinity Commercial |
$120.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.54
|
| Rate for Payer: Mclaren Medicaid |
$56.02
|
| Rate for Payer: Meridian Medicaid |
$58.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.72
|
| Rate for Payer: PACE SWMI |
$83.54
|
| Rate for Payer: PHP Medicare Advantage |
$83.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.84
|
| Rate for Payer: Priority Health Medicare |
$83.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.54
|
| Rate for Payer: UHC Medicare Advantage |
$86.05
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 96170
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$113.38 |
| Rate for Payer: Aetna Commercial |
$84.24
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS Trust/PPO |
$66.04
|
| Rate for Payer: BCN Commercial |
$113.38
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.91
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 96171
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$102.49 |
| Rate for Payer: Aetna Commercial |
$30.11
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Trust/PPO |
$102.49
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.48
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN
|
Professional
|
Both
|
$142.00
|
|
|
Service Code
|
HCPCS 96167
|
| Min. Negotiated Rate |
$39.62 |
| Max. Negotiated Rate |
$115.70 |
| Rate for Payer: Aetna Commercial |
$80.61
|
| Rate for Payer: Aetna Medicare |
$62.57
|
| Rate for Payer: BCBS Complete |
$41.60
|
| Rate for Payer: BCBS MAPPO |
$60.16
|
| Rate for Payer: BCBS Trust/PPO |
$115.70
|
| Rate for Payer: BCN Commercial |
$99.69
|
| Rate for Payer: BCN Medicare Advantage |
$60.16
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cofinity Commercial |
$80.61
|
| Rate for Payer: Cofinity Commercial |
$86.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.16
|
| Rate for Payer: Mclaren Medicaid |
$39.62
|
| Rate for Payer: Meridian Medicaid |
$41.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$63.17
|
| Rate for Payer: PACE SWMI |
$60.16
|
| Rate for Payer: PHP Medicare Advantage |
$60.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.40
|
| Rate for Payer: Priority Health Medicare |
$60.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.16
|
| Rate for Payer: UHC Medicare Advantage |
$61.96
|
|
|
PR HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 96168
|
| Min. Negotiated Rate |
$14.06 |
| Max. Negotiated Rate |
$168.53 |
| Rate for Payer: Aetna Commercial |
$28.35
|
| Rate for Payer: Aetna Medicare |
$22.01
|
| Rate for Payer: BCBS Complete |
$14.76
|
| Rate for Payer: BCBS MAPPO |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$168.53
|
| Rate for Payer: BCN Commercial |
$35.19
|
| Rate for Payer: BCN Medicare Advantage |
$21.16
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$30.47
|
| Rate for Payer: Cofinity Commercial |
$28.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.16
|
| Rate for Payer: Mclaren Medicaid |
$14.06
|
| Rate for Payer: Meridian Medicaid |
$14.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.22
|
| Rate for Payer: PACE SWMI |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$21.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.30
|
| Rate for Payer: Priority Health Medicare |
$21.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.16
|
| Rate for Payer: UHC Medicare Advantage |
$21.79
|
|
|
PR HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 96158
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$831.54 |
| Rate for Payer: Aetna Commercial |
$76.07
|
| Rate for Payer: Aetna Medicare |
$59.04
|
| Rate for Payer: BCBS Complete |
$39.36
|
| Rate for Payer: BCBS MAPPO |
$56.77
|
| Rate for Payer: BCBS Trust/PPO |
$831.54
|
| Rate for Payer: BCN Commercial |
$93.82
|
| Rate for Payer: BCN Medicare Advantage |
$56.77
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cofinity Commercial |
$81.75
|
| Rate for Payer: Cofinity Commercial |
$76.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.77
|
| Rate for Payer: Mclaren Medicaid |
$37.49
|
| Rate for Payer: Meridian Medicaid |
$39.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$59.61
|
| Rate for Payer: PACE SWMI |
$56.77
|
| Rate for Payer: PHP Medicare Advantage |
$56.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.91
|
| Rate for Payer: Priority Health Medicare |
$56.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.77
|
| Rate for Payer: UHC Medicare Advantage |
$58.47
|
|
|
PR HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 96159
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$208.15 |
| Rate for Payer: Aetna Commercial |
$26.09
|
| Rate for Payer: Aetna Medicare |
$20.25
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$19.47
|
| Rate for Payer: BCBS Trust/PPO |
$208.15
|
| Rate for Payer: BCN Commercial |
$32.25
|
| Rate for Payer: BCN Medicare Advantage |
$19.47
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$28.04
|
| Rate for Payer: Cofinity Commercial |
$26.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.47
|
| Rate for Payer: Mclaren Medicaid |
$12.57
|
| Rate for Payer: Meridian Medicaid |
$13.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.44
|
| Rate for Payer: PACE SWMI |
$19.47
|
| Rate for Payer: PHP Medicare Advantage |
$19.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.04
|
| Rate for Payer: Priority Health Medicare |
$19.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.47
|
| Rate for Payer: UHC Medicare Advantage |
$20.05
|
|
|
PR HEALTH RISK ASSESSMENT TEST
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 99420
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$35.00 |
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
|
|
PR HEARING AID CHECK BINAURAL
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS 92593
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$392.83 |
| Rate for Payer: Aetna Commercial |
$39.35
|
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: BCBS Trust/PPO |
$392.83
|
| Rate for Payer: BCN Commercial |
$47.99
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.41
|
|
|
PR HEARING AID CHECK MONAURAL
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 92592
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$2,403.24 |
| Rate for Payer: Aetna Commercial |
$23.53
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,403.24
|
| Rate for Payer: BCN Commercial |
$47.99
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.09
|
|
|
PR HEARING AID EXAMINATION & SELECTION BINAURAL
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 92591
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$864.19 |
| Rate for Payer: Aetna Commercial |
$76.88
|
| Rate for Payer: BCBS Complete |
$56.00
|
| Rate for Payer: BCBS Trust/PPO |
$864.19
|
| Rate for Payer: BCN Commercial |
$98.85
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$96.12
|
|
|
PR HEARING AID EXAMINATION & SELECTION MONAURAL
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 92590
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$1,399.47 |
| Rate for Payer: Aetna Commercial |
$59.96
|
| Rate for Payer: BCBS Complete |
$56.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,399.47
|
| Rate for Payer: BCN Commercial |
$98.85
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.46
|
|
|
PR HEARING AID, PROG, BIN, BTE
|
Professional
|
Both
|
$5,408.00
|
|
|
Service Code
|
HCPCS V5253
|
| Min. Negotiated Rate |
$1,350.00 |
| Max. Negotiated Rate |
$3,785.60 |
| Rate for Payer: Aetna Commercial |
$1,350.00
|
| Rate for Payer: BCBS Complete |
$2,163.20
|
| Rate for Payer: Cash Price |
$4,326.40
|
| Rate for Payer: Cash Price |
$4,326.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,785.60
|
|
|
PR HEARING AID REPAIR/MODIFYING
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS V5014
|
| Min. Negotiated Rate |
$88.69 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: BCBS Complete |
$170.00
|
| Rate for Payer: BCBS Complete |
$40.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Cash Price |
$340.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.50
|
|
|
PR HEARING AID RESTOCKING FEE
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 00663
|
|
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 HEMIARTHROPLASTY HIP PARTIAL
|
Professional
|
Both
|
$2,287.54
|
|
|
Service Code
|
HCPCS 27125
|
| Min. Negotiated Rate |
$726.97 |
| Max. Negotiated Rate |
$1,730.08 |
| Rate for Payer: Aetna Commercial |
$1,493.58
|
| Rate for Payer: Aetna Medicare |
$1,159.19
|
| Rate for Payer: BCBS Complete |
$763.32
|
| Rate for Payer: BCBS MAPPO |
$1,114.61
|
| Rate for Payer: BCBS Trust/PPO |
$984.22
|
| Rate for Payer: BCN Commercial |
$1,655.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,114.61
|
| Rate for Payer: Cash Price |
$1,830.03
|
| Rate for Payer: Cash Price |
$1,830.03
|
| Rate for Payer: Cofinity Commercial |
$1,493.58
|
| Rate for Payer: Cofinity Commercial |
$1,605.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,114.61
|
| Rate for Payer: Mclaren Medicaid |
$726.97
|
| Rate for Payer: Meridian Medicaid |
$763.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,170.34
|
| Rate for Payer: PACE SWMI |
$1,114.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,114.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$726.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,601.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,730.08
|
| Rate for Payer: Priority Health Medicare |
$1,114.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,730.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,114.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,114.61
|
| Rate for Payer: UHC Medicare Advantage |
$1,148.05
|
|
|
PR HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE
|
Professional
|
Both
|
$683.00
|
|
|
Service Code
|
HCPCS 28160
|
| Min. Negotiated Rate |
$172.53 |
| Max. Negotiated Rate |
$888.60 |
| Rate for Payer: Aetna Commercial |
$346.42
|
| Rate for Payer: Aetna Medicare |
$268.86
|
| Rate for Payer: BCBS Complete |
$181.16
|
| Rate for Payer: BCBS MAPPO |
$258.52
|
| Rate for Payer: BCBS Trust/PPO |
$888.60
|
| Rate for Payer: BCN Commercial |
$592.77
|
| Rate for Payer: BCN Medicare Advantage |
$258.52
|
| Rate for Payer: Cash Price |
$546.40
|
| Rate for Payer: Cash Price |
$546.40
|
| Rate for Payer: Cofinity Commercial |
$346.42
|
| Rate for Payer: Cofinity Commercial |
$372.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.52
|
| Rate for Payer: Mclaren Medicaid |
$172.53
|
| Rate for Payer: Meridian Medicaid |
$181.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$271.45
|
| Rate for Payer: PACE SWMI |
$258.52
|
| Rate for Payer: PHP Medicare Advantage |
$258.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$404.95
|
| Rate for Payer: Priority Health Medicare |
$258.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$404.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$258.52
|
| Rate for Payer: UHC Medicare Advantage |
$266.28
|
|
|
PR HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 90935
|
| Min. Negotiated Rate |
$44.73 |
| Max. Negotiated Rate |
$293.73 |
| Rate for Payer: Aetna Commercial |
$94.01
|
| Rate for Payer: Aetna Medicare |
$72.97
|
| Rate for Payer: BCBS Complete |
$46.97
|
| Rate for Payer: BCBS MAPPO |
$70.16
|
| Rate for Payer: BCBS Trust/PPO |
$293.73
|
| Rate for Payer: BCN Commercial |
$103.11
|
| Rate for Payer: BCN Medicare Advantage |
$70.16
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$94.01
|
| Rate for Payer: Cofinity Commercial |
$101.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.16
|
| Rate for Payer: Mclaren Medicaid |
$44.73
|
| Rate for Payer: Meridian Medicaid |
$46.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$73.67
|
| Rate for Payer: PACE SWMI |
$70.16
|
| Rate for Payer: PHP Medicare Advantage |
$70.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.77
|
| Rate for Payer: Priority Health Medicare |
$70.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.16
|
| Rate for Payer: UHC Medicare Advantage |
$72.26
|
|
