|
PR IMM ADMN SARSCOV2 BIVALENT 3 MCG/0.2 ML ADDL
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 0174A
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$26.78
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.00
|
|
|
PR IMM ADMN SARSCOV2 BIVALENT 50 MCG/0.5 ML ADDL
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 0134A
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$1,882.66 |
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,882.66
|
| Rate for Payer: BCN Commercial |
$26.78
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.00
|
|
|
PR IMM ADMN SARSCOV2 VACCINE SINGLE DOSE
|
Professional
|
Both
|
$83.04
|
|
|
Service Code
|
HCPCS 90480
|
| Min. Negotiated Rate |
$33.22 |
| Max. Negotiated Rate |
$58.13 |
| Rate for Payer: Aetna Commercial |
$40.00
|
| Rate for Payer: BCBS Complete |
$33.22
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.98
|
|
|
PR IMMUNIZE COUNS < 21YR 5-15 M
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS G0312
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
|
|
PR IMMUNIZE COUNS < 21YR 6-30 M
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS G0313
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.50
|
|
|
PR IMMUNIZE COUNSEL 16-30 MINS
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS G0311
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.50
|
|
|
PR IMMUNIZE COUNSEL 5-15 MIN
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS G0310
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
|
|
PR IMPLANTATION NERVE END BONE/MUSCLE
|
Professional
|
Both
|
$1,817.00
|
|
|
Service Code
|
HCPCS 64787
|
| Min. Negotiated Rate |
$136.83 |
| Max. Negotiated Rate |
$1,271.90 |
| Rate for Payer: Aetna Commercial |
$311.88
|
| Rate for Payer: Aetna Medicare |
$242.06
|
| Rate for Payer: BCBS Complete |
$155.21
|
| Rate for Payer: BCBS MAPPO |
$232.75
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: BCN Commercial |
$341.58
|
| Rate for Payer: BCN Medicare Advantage |
$232.75
|
| Rate for Payer: Cash Price |
$1,453.60
|
| Rate for Payer: Cash Price |
$1,453.60
|
| Rate for Payer: Cofinity Commercial |
$335.16
|
| Rate for Payer: Cofinity Commercial |
$311.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.75
|
| Rate for Payer: Mclaren Medicaid |
$147.82
|
| Rate for Payer: Meridian Medicaid |
$155.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$244.39
|
| Rate for Payer: PACE SWMI |
$232.75
|
| Rate for Payer: PHP Medicare Advantage |
$232.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,271.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$395.79
|
| Rate for Payer: Priority Health Medicare |
$232.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$395.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$232.75
|
| Rate for Payer: UHC Medicare Advantage |
$239.73
|
|
|
PR IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER
|
Professional
|
Both
|
$618.00
|
|
|
Service Code
|
HCPCS 33282
|
| Min. Negotiated Rate |
$247.20 |
| Max. Negotiated Rate |
$432.60 |
| Rate for Payer: BCBS Complete |
$247.20
|
| Rate for Payer: Cash Price |
$494.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.60
|
|
|
PR IMPLANT MESH OPN HERNIA RPR/DEBRIDEMENT CLOSURE
|
Professional
|
Both
|
$990.00
|
|
|
Service Code
|
HCPCS 49568
|
| Min. Negotiated Rate |
$396.00 |
| Max. Negotiated Rate |
$693.00 |
| Rate for Payer: BCBS Complete |
$396.00
|
| Rate for Payer: Cash Price |
$792.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$693.00
|
|
|
PR IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT
|
Professional
|
Both
|
$439.00
|
|
|
Service Code
|
HCPCS 15777
|
| Min. Negotiated Rate |
$135.68 |
| Max. Negotiated Rate |
$311.29 |
| Rate for Payer: Aetna Commercial |
$283.44
|
| Rate for Payer: Aetna Medicare |
$219.98
|
| Rate for Payer: BCBS Complete |
$142.46
|
| Rate for Payer: BCBS MAPPO |
$211.52
|
| Rate for Payer: BCBS Trust/PPO |
$150.00
|
| Rate for Payer: BCN Commercial |
$311.29
|
| Rate for Payer: BCN Medicare Advantage |
$211.52
|
| Rate for Payer: Cash Price |
$351.20
|
| Rate for Payer: Cash Price |
$351.20
|
| Rate for Payer: Cofinity Commercial |
$283.44
|
| Rate for Payer: Cofinity Commercial |
$304.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.52
|
| Rate for Payer: Mclaren Medicaid |
$135.68
|
| Rate for Payer: Meridian Medicaid |
$142.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$222.10
|
| Rate for Payer: PACE SWMI |
$211.52
|
| Rate for Payer: PHP Medicare Advantage |
$211.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$135.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$307.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.83
|
| Rate for Payer: Priority Health Medicare |
$211.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$211.52
|
| Rate for Payer: UHC Medicare Advantage |
$217.87
|
|
|
PR IMPL OI IMPLT SKULL MAG TC ATTACHMENT ESP<100
|
Professional
|
Both
|
$1,317.00
|
|
|
Service Code
|
HCPCS 69716
|
| Min. Negotiated Rate |
$176.45 |
| Max. Negotiated Rate |
$921.90 |
| Rate for Payer: Aetna Commercial |
$816.76
|
| Rate for Payer: Aetna Medicare |
$633.90
|
| Rate for Payer: BCBS Complete |
$417.77
|
| Rate for Payer: BCBS MAPPO |
$609.52
|
| Rate for Payer: BCBS Trust/PPO |
$176.45
|
| Rate for Payer: BCN Commercial |
$910.40
|
| Rate for Payer: BCN Medicare Advantage |
$609.52
|
| Rate for Payer: Cash Price |
$1,053.60
|
| Rate for Payer: Cash Price |
$1,053.60
|
| Rate for Payer: Cofinity Commercial |
$877.71
|
| Rate for Payer: Cofinity Commercial |
$816.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$609.52
|
| Rate for Payer: Mclaren Medicaid |
$397.88
|
| Rate for Payer: Meridian Medicaid |
$417.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$640.00
|
| Rate for Payer: PACE SWMI |
$609.52
|
| Rate for Payer: PHP Medicare Advantage |
$609.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$397.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.33
|
| Rate for Payer: Priority Health Medicare |
$609.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$878.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$609.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$609.52
|
| Rate for Payer: UHC Medicare Advantage |
$627.81
|
|
|
PR IMPL OI IMPLT SKULL PERQ ATTACHMENT ESP
|
Professional
|
Both
|
$1,915.00
|
|
|
Service Code
|
HCPCS 69714
|
| Min. Negotiated Rate |
$318.01 |
| Max. Negotiated Rate |
$3,343.08 |
| Rate for Payer: Aetna Commercial |
$648.01
|
| Rate for Payer: Aetna Medicare |
$502.93
|
| Rate for Payer: BCBS Complete |
$333.91
|
| Rate for Payer: BCBS MAPPO |
$483.59
|
| Rate for Payer: BCBS Trust/PPO |
$3,343.08
|
| Rate for Payer: BCN Commercial |
$725.20
|
| Rate for Payer: BCN Medicare Advantage |
$483.59
|
| Rate for Payer: Cash Price |
$1,532.00
|
| Rate for Payer: Cash Price |
$1,532.00
|
| Rate for Payer: Cofinity Commercial |
$696.37
|
| Rate for Payer: Cofinity Commercial |
$648.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$483.59
|
| Rate for Payer: Mclaren Medicaid |
$318.01
|
| Rate for Payer: Meridian Medicaid |
$333.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$507.77
|
| Rate for Payer: PACE SWMI |
$483.59
|
| Rate for Payer: PHP Medicare Advantage |
$483.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$318.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,340.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$699.65
|
| Rate for Payer: Priority Health Medicare |
$483.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$699.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$483.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$483.59
|
| Rate for Payer: UHC Medicare Advantage |
$498.10
|
|
|
PR IMPLTJ BRAIN INTRACAVITARY CHEMOTHERAPY AGENT
|
Professional
|
Both
|
$411.00
|
|
|
Service Code
|
HCPCS 61517
|
| Min. Negotiated Rate |
$55.81 |
| Max. Negotiated Rate |
$975.77 |
| Rate for Payer: Aetna Commercial |
$117.25
|
| Rate for Payer: Aetna Medicare |
$91.00
|
| Rate for Payer: BCBS Complete |
$58.60
|
| Rate for Payer: BCBS MAPPO |
$87.50
|
| Rate for Payer: BCBS Trust/PPO |
$975.77
|
| Rate for Payer: BCN Commercial |
$127.06
|
| Rate for Payer: BCN Medicare Advantage |
$87.50
|
| Rate for Payer: Cash Price |
$328.80
|
| Rate for Payer: Cash Price |
$328.80
|
| Rate for Payer: Cofinity Commercial |
$126.00
|
| Rate for Payer: Cofinity Commercial |
$117.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.50
|
| Rate for Payer: Mclaren Medicaid |
$55.81
|
| Rate for Payer: Meridian Medicaid |
$58.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.88
|
| Rate for Payer: PACE SWMI |
$87.50
|
| Rate for Payer: PHP Medicare Advantage |
$87.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$147.22
|
| Rate for Payer: Priority Health Medicare |
$87.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$147.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.50
|
| Rate for Payer: UHC Medicare Advantage |
$90.12
|
|
|
PR IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM
|
Professional
|
Both
|
$805.28
|
|
|
Service Code
|
HCPCS 62350
|
| Min. Negotiated Rate |
$256.45 |
| Max. Negotiated Rate |
$1,703.77 |
| Rate for Payer: Aetna Commercial |
$525.49
|
| Rate for Payer: Aetna Medicare |
$407.85
|
| Rate for Payer: BCBS Complete |
$269.27
|
| Rate for Payer: BCBS MAPPO |
$392.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,703.77
|
| Rate for Payer: BCN Commercial |
$581.53
|
| Rate for Payer: BCN Medicare Advantage |
$392.16
|
| Rate for Payer: Cash Price |
$644.22
|
| Rate for Payer: Cash Price |
$644.22
|
| Rate for Payer: Cofinity Commercial |
$525.49
|
| Rate for Payer: Cofinity Commercial |
$564.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$392.16
|
| Rate for Payer: Mclaren Medicaid |
$256.45
|
| Rate for Payer: Meridian Medicaid |
$269.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$411.77
|
| Rate for Payer: PACE SWMI |
$392.16
|
| Rate for Payer: PHP Medicare Advantage |
$392.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$673.81
|
| Rate for Payer: Priority Health Medicare |
$392.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$673.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$392.16
|
| Rate for Payer: UHC Medicare Advantage |
$403.92
|
|
|
PR IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP
|
Professional
|
Both
|
$2,476.00
|
|
|
Service Code
|
HCPCS 62362
|
| Min. Negotiated Rate |
$248.78 |
| Max. Negotiated Rate |
$1,733.20 |
| Rate for Payer: Aetna Commercial |
$510.02
|
| Rate for Payer: Aetna Medicare |
$395.83
|
| Rate for Payer: BCBS Complete |
$261.22
|
| Rate for Payer: BCBS MAPPO |
$380.61
|
| Rate for Payer: BCBS Trust/PPO |
$311.17
|
| Rate for Payer: BCN Commercial |
$564.43
|
| Rate for Payer: BCN Medicare Advantage |
$380.61
|
| Rate for Payer: Cash Price |
$1,980.80
|
| Rate for Payer: Cash Price |
$1,980.80
|
| Rate for Payer: Cofinity Commercial |
$548.08
|
| Rate for Payer: Cofinity Commercial |
$510.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.61
|
| Rate for Payer: Mclaren Medicaid |
$248.78
|
| Rate for Payer: Meridian Medicaid |
$261.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$399.64
|
| Rate for Payer: PACE SWMI |
$380.61
|
| Rate for Payer: PHP Medicare Advantage |
$380.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,733.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$653.99
|
| Rate for Payer: Priority Health Medicare |
$380.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$653.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$380.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$380.61
|
| Rate for Payer: UHC Medicare Advantage |
$392.03
|
|
|
PR IMPREG GAUZE NO H20/SAL/YARD
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS A6266
|
| Min. Negotiated Rate |
$1.78 |
| Max. Negotiated Rate |
$4.90 |
| Rate for Payer: Aetna Commercial |
$1.78
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: BCN Commercial |
$2.11
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.90
|
|
|
PR INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW
|
Professional
|
Both
|
$1,468.00
|
|
|
Service Code
|
HCPCS 23935
|
| Min. Negotiated Rate |
$67.50 |
| Max. Negotiated Rate |
$1,027.60 |
| Rate for Payer: Aetna Commercial |
$678.12
|
| Rate for Payer: Aetna Medicare |
$526.30
|
| Rate for Payer: BCBS Complete |
$352.02
|
| Rate for Payer: BCBS MAPPO |
$506.06
|
| Rate for Payer: BCBS Trust/PPO |
$67.50
|
| Rate for Payer: BCN Commercial |
$759.90
|
| Rate for Payer: BCN Medicare Advantage |
$506.06
|
| Rate for Payer: Cash Price |
$1,174.40
|
| Rate for Payer: Cash Price |
$1,174.40
|
| Rate for Payer: Cofinity Commercial |
$728.73
|
| Rate for Payer: Cofinity Commercial |
$678.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$506.06
|
| Rate for Payer: Mclaren Medicaid |
$335.26
|
| Rate for Payer: Meridian Medicaid |
$352.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$531.36
|
| Rate for Payer: PACE SWMI |
$506.06
|
| Rate for Payer: PHP Medicare Advantage |
$506.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$335.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$794.07
|
| Rate for Payer: Priority Health Medicare |
$506.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$794.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$506.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$506.06
|
| Rate for Payer: UHC Medicare Advantage |
$521.24
|
|
|
PR INC DEEP W/OPNG BONE CORTEX FEMUR/KNEE
|
Professional
|
Both
|
$1,539.00
|
|
|
Service Code
|
HCPCS 27303
|
| Min. Negotiated Rate |
$415.99 |
| Max. Negotiated Rate |
$2,493.05 |
| Rate for Payer: Aetna Commercial |
$843.56
|
| Rate for Payer: Aetna Medicare |
$654.70
|
| Rate for Payer: BCBS Complete |
$436.79
|
| Rate for Payer: BCBS MAPPO |
$629.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,493.05
|
| Rate for Payer: BCN Commercial |
$939.73
|
| Rate for Payer: BCN Medicare Advantage |
$629.52
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cash Price |
$1,231.20
|
| Rate for Payer: Cofinity Commercial |
$843.56
|
| Rate for Payer: Cofinity Commercial |
$906.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$629.52
|
| Rate for Payer: Mclaren Medicaid |
$415.99
|
| Rate for Payer: Meridian Medicaid |
$436.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$661.00
|
| Rate for Payer: PACE SWMI |
$629.52
|
| Rate for Payer: PHP Medicare Advantage |
$629.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$415.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,077.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$981.98
|
| Rate for Payer: Priority Health Medicare |
$629.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$981.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$629.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$629.52
|
| Rate for Payer: UHC Medicare Advantage |
$648.41
|
|
|
PR INCISE&RETRIEVAL SUBQ CRANIOPLASTY BONE GRAFT
|
Professional
|
Both
|
$576.00
|
|
|
Service Code
|
HCPCS 62148
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$403.20 |
| Rate for Payer: Aetna Commercial |
$169.62
|
| Rate for Payer: Aetna Medicare |
$131.64
|
| Rate for Payer: BCBS Complete |
$84.54
|
| Rate for Payer: BCBS MAPPO |
$126.58
|
| Rate for Payer: BCBS Trust/PPO |
$50.72
|
| Rate for Payer: BCN Commercial |
$254.90
|
| Rate for Payer: BCN Medicare Advantage |
$126.58
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cash Price |
$460.80
|
| Rate for Payer: Cofinity Commercial |
$182.28
|
| Rate for Payer: Cofinity Commercial |
$169.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.58
|
| Rate for Payer: Mclaren Medicaid |
$80.51
|
| Rate for Payer: Meridian Medicaid |
$84.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$132.91
|
| Rate for Payer: PACE SWMI |
$126.58
|
| Rate for Payer: PHP Medicare Advantage |
$126.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$403.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.91
|
| Rate for Payer: Priority Health Medicare |
$126.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.58
|
| Rate for Payer: UHC Medicare Advantage |
$130.38
|
|
|
PR INCIS HEART SAC TUBE
|
Professional
|
Both
|
$1,650.00
|
|
|
Service Code
|
HCPCS 33015
|
| Min. Negotiated Rate |
$660.00 |
| Max. Negotiated Rate |
$1,155.00 |
| Rate for Payer: BCBS Complete |
$660.00
|
| Rate for Payer: Cash Price |
$1,320.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,155.00
|
|
|
PR INCISIONAL BIOPSY EYELID SKIN & LID MARGIN
|
Professional
|
Both
|
$358.00
|
|
|
Service Code
|
HCPCS 67810
|
| Min. Negotiated Rate |
$42.81 |
| Max. Negotiated Rate |
$562.64 |
| Rate for Payer: Aetna Commercial |
$88.75
|
| Rate for Payer: Aetna Medicare |
$68.88
|
| Rate for Payer: BCBS Complete |
$44.95
|
| Rate for Payer: BCBS MAPPO |
$66.23
|
| Rate for Payer: BCBS Trust/PPO |
$562.64
|
| Rate for Payer: BCN Commercial |
$271.22
|
| Rate for Payer: BCN Medicare Advantage |
$66.23
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cash Price |
$286.40
|
| Rate for Payer: Cofinity Commercial |
$95.37
|
| Rate for Payer: Cofinity Commercial |
$88.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.23
|
| Rate for Payer: Mclaren Medicaid |
$42.81
|
| Rate for Payer: Meridian Medicaid |
$44.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.54
|
| Rate for Payer: PACE SWMI |
$66.23
|
| Rate for Payer: PHP Medicare Advantage |
$66.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.66
|
| Rate for Payer: Priority Health Medicare |
$66.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.23
|
| Rate for Payer: UHC Medicare Advantage |
$68.22
|
|
|
PR INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION
|
Professional
|
Both
|
$139.00
|
|
|
Service Code
|
HCPCS 11107
|
| Min. Negotiated Rate |
$11.47 |
| Max. Negotiated Rate |
$97.30 |
| Rate for Payer: Aetna Commercial |
$40.35
|
| Rate for Payer: Aetna Medicare |
$31.31
|
| Rate for Payer: BCBS Complete |
$20.35
|
| Rate for Payer: BCBS MAPPO |
$30.11
|
| Rate for Payer: BCBS Trust/PPO |
$11.47
|
| Rate for Payer: BCN Commercial |
$84.42
|
| Rate for Payer: BCN Medicare Advantage |
$30.11
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cofinity Commercial |
$43.36
|
| Rate for Payer: Cofinity Commercial |
$40.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.11
|
| Rate for Payer: Mclaren Medicaid |
$19.38
|
| Rate for Payer: Meridian Medicaid |
$20.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.62
|
| Rate for Payer: PACE SWMI |
$30.11
|
| Rate for Payer: PHP Medicare Advantage |
$30.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.41
|
| Rate for Payer: Priority Health Medicare |
$30.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.11
|
| Rate for Payer: UHC Medicare Advantage |
$31.01
|
|
|
PR INCISIONAL BIOPSY SKIN SINGLE LESION
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS 11106
|
| Min. Negotiated Rate |
$13.57 |
| Max. Negotiated Rate |
$202.30 |
| Rate for Payer: Aetna Commercial |
$74.06
|
| Rate for Payer: Aetna Medicare |
$57.48
|
| Rate for Payer: BCBS Complete |
$37.57
|
| Rate for Payer: BCBS MAPPO |
$55.27
|
| Rate for Payer: BCBS Trust/PPO |
$13.57
|
| Rate for Payer: BCN Commercial |
$183.77
|
| Rate for Payer: BCN Medicare Advantage |
$55.27
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cofinity Commercial |
$79.59
|
| Rate for Payer: Cofinity Commercial |
$74.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.27
|
| Rate for Payer: Mclaren Medicaid |
$35.78
|
| Rate for Payer: Meridian Medicaid |
$37.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$58.03
|
| Rate for Payer: PACE SWMI |
$55.27
|
| Rate for Payer: PHP Medicare Advantage |
$55.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$202.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.64
|
| Rate for Payer: Priority Health Medicare |
$55.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.27
|
| Rate for Payer: UHC Medicare Advantage |
$56.93
|
|
|
PR INCISION AND DRAINAGE APPENDICEAL ABSCESS OPEN
|
Professional
|
Both
|
$1,359.00
|
|
|
Service Code
|
HCPCS 44900
|
| Min. Negotiated Rate |
$378.79 |
| Max. Negotiated Rate |
$1,382.33 |
| Rate for Payer: Aetna Commercial |
$1,047.10
|
| Rate for Payer: Aetna Medicare |
$812.68
|
| Rate for Payer: BCBS Complete |
$528.03
|
| Rate for Payer: BCBS MAPPO |
$781.42
|
| Rate for Payer: BCBS Trust/PPO |
$378.79
|
| Rate for Payer: BCN Commercial |
$1,148.88
|
| Rate for Payer: BCN Medicare Advantage |
$781.42
|
| Rate for Payer: Cash Price |
$1,087.20
|
| Rate for Payer: Cash Price |
$1,087.20
|
| Rate for Payer: Cofinity Commercial |
$1,125.24
|
| Rate for Payer: Cofinity Commercial |
$1,047.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.42
|
| Rate for Payer: Mclaren Medicaid |
$502.89
|
| Rate for Payer: Meridian Medicaid |
$528.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$820.49
|
| Rate for Payer: PACE SWMI |
$781.42
|
| Rate for Payer: PHP Medicare Advantage |
$781.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$502.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$951.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,382.33
|
| Rate for Payer: Priority Health Medicare |
$781.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,382.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$781.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$781.42
|
| Rate for Payer: UHC Medicare Advantage |
$804.86
|
|
