|
PR BETAMETHASONE ACET&SOD PHOSP
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J0702
|
| Min. Negotiated Rate |
$3.84 |
| Max. Negotiated Rate |
$9.92 |
| Rate for Payer: Aetna Commercial |
$9.23
|
| Rate for Payer: Aetna Medicare |
$7.16
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$6.89
|
| Rate for Payer: BCBS Trust/PPO |
$3.84
|
| Rate for Payer: BCN Commercial |
$4.80
|
| Rate for Payer: BCN Medicare Advantage |
$6.89
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$9.23
|
| Rate for Payer: Cofinity Commercial |
$9.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.23
|
| Rate for Payer: Nomi Health Commercial |
$8.27
|
| Rate for Payer: PACE SWMI |
$6.89
|
| Rate for Payer: PHP Medicare Advantage |
$6.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health Medicare |
$6.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.89
|
| Rate for Payer: UHC Exchange |
$6.89
|
| Rate for Payer: UHC Medicare Advantage |
$6.89
|
|
|
PR BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 90912
|
| Min. Negotiated Rate |
$40.06 |
| Max. Negotiated Rate |
$184.91 |
| Rate for Payer: Aetna Commercial |
$53.68
|
| Rate for Payer: Aetna Medicare |
$41.66
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: BCBS MAPPO |
$40.06
|
| Rate for Payer: BCBS Trust/PPO |
$184.91
|
| Rate for Payer: BCN Commercial |
$117.28
|
| Rate for Payer: BCN Medicare Advantage |
$40.06
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$57.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.06
|
| Rate for Payer: Nomi Health Commercial |
$48.07
|
| Rate for Payer: PACE SWMI |
$40.06
|
| Rate for Payer: PHP Medicare Advantage |
$40.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health HMO/PPO |
$65.04
|
| Rate for Payer: Priority Health Medicare |
$40.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.06
|
| Rate for Payer: UHC Exchange |
$40.06
|
| Rate for Payer: UHC Medicare Advantage |
$40.06
|
|
|
PR BIA WHOLE BODY COMPOSITION ASSESSMENT W/I&R
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 0358T
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$29.66 |
| Rate for Payer: Aetna Commercial |
$29.66
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$23.09
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
|
|
PR BILATERAL GYNECOMASTIA
|
Professional
|
Both
|
$3,264.00
|
|
|
Service Code
|
HCPCS 00524
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,305.60 |
| Max. Negotiated Rate |
$2,121.60 |
| Rate for Payer: Aetna Medicare |
$1,632.00
|
| Rate for Payer: BCBS Complete |
$1,305.60
|
| Rate for Payer: Cash Price |
$2,611.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,121.60
|
|
|
PR BILATERAL MASTOPEXY
|
Professional
|
Both
|
$3,876.00
|
|
|
Service Code
|
HCPCS 00525
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,550.40 |
| Max. Negotiated Rate |
$2,519.40 |
| Rate for Payer: Aetna Medicare |
$1,938.00
|
| Rate for Payer: BCBS Complete |
$1,550.40
|
| Rate for Payer: Cash Price |
$3,100.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,519.40
|
|
|
PR BILATERAL OTOPLASTY
|
Professional
|
Both
|
$3,162.00
|
|
|
Service Code
|
HCPCS 00533
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,264.80 |
| Max. Negotiated Rate |
$2,055.30 |
| Rate for Payer: Aetna Medicare |
$1,581.00
|
| Rate for Payer: BCBS Complete |
$1,264.80
|
| Rate for Payer: Cash Price |
$2,529.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,055.30
|
|
|
PR BILATERAL REDUCTION MAMMOPLASTY
|
Professional
|
Both
|
$3,876.00
|
|
|
Service Code
|
HCPCS 00526
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,550.40 |
| Max. Negotiated Rate |
$2,519.40 |
| Rate for Payer: Aetna Medicare |
$1,938.00
|
| Rate for Payer: BCBS Complete |
$1,550.40
|
| Rate for Payer: Cash Price |
$3,100.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,519.40
|
|
|
PR BILATERAL THORACIC ROLL EXCISION
|
Professional
|
Both
|
$2,754.00
|
|
|
Service Code
|
HCPCS 00543
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,101.60 |
| Max. Negotiated Rate |
$1,790.10 |
| Rate for Payer: Aetna Medicare |
$1,377.00
|
| Rate for Payer: BCBS Complete |
$1,101.60
|
| Rate for Payer: Cash Price |
$2,203.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,790.10
|
|
|
PR BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS
|
Professional
|
Both
|
$916.00
|
|
|
Service Code
|
HCPCS 47554
|
| Min. Negotiated Rate |
$282.23 |
| Max. Negotiated Rate |
$7,499.75 |
| Rate for Payer: Aetna Commercial |
$572.19
|
| Rate for Payer: Aetna Medicare |
$444.09
|
| Rate for Payer: BCBS Complete |
$296.34
|
| Rate for Payer: BCBS MAPPO |
$427.01
|
| Rate for Payer: BCBS Trust/PPO |
$7,499.75
|
| Rate for Payer: BCN Commercial |
$642.61
|
| Rate for Payer: BCN Medicare Advantage |
$427.01
|
| Rate for Payer: Cash Price |
$732.80
|
| Rate for Payer: Cash Price |
$732.80
|
| Rate for Payer: Cofinity Commercial |
$614.89
|
| Rate for Payer: Cofinity Commercial |
$572.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$427.01
|
| Rate for Payer: Mclaren Medicaid |
$282.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$448.36
|
| Rate for Payer: Meridian Medicaid |
$296.34
|
| Rate for Payer: Nomi Health Commercial |
$512.41
|
| Rate for Payer: PACE SWMI |
$427.01
|
| Rate for Payer: PHP Medicare Advantage |
$427.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$595.40
|
| Rate for Payer: Priority Health HMO/PPO |
$783.93
|
| Rate for Payer: Priority Health Medicare |
$431.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$783.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$427.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$427.01
|
| Rate for Payer: UHC Exchange |
$427.01
|
| Rate for Payer: UHC Medicare Advantage |
$427.01
|
| Rate for Payer: UHCCP Medicaid |
$282.23
|
|
|
PR BILIARY NDSC INTRAOPERATIVE
|
Professional
|
Both
|
$530.00
|
|
|
Service Code
|
HCPCS 47550
|
| Min. Negotiated Rate |
$103.31 |
| Max. Negotiated Rate |
$5,071.68 |
| Rate for Payer: Aetna Commercial |
$211.22
|
| Rate for Payer: Aetna Medicare |
$163.94
|
| Rate for Payer: BCBS Complete |
$108.48
|
| Rate for Payer: BCBS MAPPO |
$157.63
|
| Rate for Payer: BCBS Trust/PPO |
$5,071.68
|
| Rate for Payer: BCN Commercial |
$237.49
|
| Rate for Payer: BCN Medicare Advantage |
$157.63
|
| Rate for Payer: Cash Price |
$424.00
|
| Rate for Payer: Cash Price |
$424.00
|
| Rate for Payer: Cofinity Commercial |
$211.22
|
| Rate for Payer: Cofinity Commercial |
$226.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.63
|
| Rate for Payer: Mclaren Medicaid |
$103.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.51
|
| Rate for Payer: Meridian Medicaid |
$108.48
|
| Rate for Payer: Nomi Health Commercial |
$189.16
|
| Rate for Payer: PACE SWMI |
$157.63
|
| Rate for Payer: PHP Medicare Advantage |
$157.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.50
|
| Rate for Payer: Priority Health HMO/PPO |
$289.34
|
| Rate for Payer: Priority Health Medicare |
$159.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.63
|
| Rate for Payer: UHC Exchange |
$157.63
|
| Rate for Payer: UHC Medicare Advantage |
$157.63
|
| Rate for Payer: UHCCP Medicaid |
$103.31
|
|
|
PR BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 92504
|
| Min. Negotiated Rate |
$8.85 |
| Max. Negotiated Rate |
$2,190.33 |
| Rate for Payer: Aetna Commercial |
$11.86
|
| Rate for Payer: Aetna Medicare |
$9.20
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS MAPPO |
$8.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,190.33
|
| Rate for Payer: BCN Commercial |
$34.16
|
| Rate for Payer: BCN Medicare Advantage |
$8.85
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$11.86
|
| Rate for Payer: Cofinity Commercial |
$12.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.29
|
| Rate for Payer: Nomi Health Commercial |
$10.62
|
| Rate for Payer: PACE SWMI |
$8.85
|
| Rate for Payer: PHP Medicare Advantage |
$8.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health HMO/PPO |
$12.22
|
| Rate for Payer: Priority Health Medicare |
$8.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.85
|
| Rate for Payer: UHC Exchange |
$8.85
|
| Rate for Payer: UHC Medicare Advantage |
$8.85
|
|
|
PR BIOFEEDBACK PERI/URO/RECTAL
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 90911
|
| Min. Negotiated Rate |
$75.20 |
| Max. Negotiated Rate |
$122.20 |
| Rate for Payer: Aetna Medicare |
$94.00
|
| Rate for Payer: BCBS Complete |
$75.20
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
|
|
PR BIOFEEDBACK TRAINING ANY MODALITY
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 90901
|
| Min. Negotiated Rate |
$18.15 |
| Max. Negotiated Rate |
$724.83 |
| Rate for Payer: Aetna Commercial |
$24.32
|
| Rate for Payer: Aetna Medicare |
$18.88
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS MAPPO |
$18.15
|
| Rate for Payer: BCBS Trust/PPO |
$724.83
|
| Rate for Payer: BCN Commercial |
$59.62
|
| Rate for Payer: BCN Medicare Advantage |
$18.15
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$24.32
|
| Rate for Payer: Cofinity Commercial |
$26.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.06
|
| Rate for Payer: Nomi Health Commercial |
$21.78
|
| Rate for Payer: PACE SWMI |
$18.15
|
| Rate for Payer: PHP Medicare Advantage |
$18.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health HMO/PPO |
$61.18
|
| Rate for Payer: Priority Health Medicare |
$18.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.15
|
| Rate for Payer: UHC Exchange |
$18.15
|
| Rate for Payer: UHC Medicare Advantage |
$18.15
|
|
|
PR BIOPSY BONE OPEN DEEP
|
Professional
|
Both
|
$1,264.00
|
|
|
Service Code
|
HCPCS 20245
|
| Min. Negotiated Rate |
$106.88 |
| Max. Negotiated Rate |
$821.60 |
| Rate for Payer: Aetna Commercial |
$440.43
|
| Rate for Payer: Aetna Medicare |
$341.83
|
| Rate for Payer: BCBS Complete |
$229.91
|
| Rate for Payer: BCBS MAPPO |
$328.68
|
| Rate for Payer: BCBS Trust/PPO |
$106.88
|
| Rate for Payer: BCN Commercial |
$499.92
|
| Rate for Payer: BCN Medicare Advantage |
$328.68
|
| Rate for Payer: Cash Price |
$1,011.20
|
| Rate for Payer: Cash Price |
$1,011.20
|
| Rate for Payer: Cofinity Commercial |
$473.30
|
| Rate for Payer: Cofinity Commercial |
$440.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.68
|
| Rate for Payer: Mclaren Medicaid |
$218.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$345.11
|
| Rate for Payer: Meridian Medicaid |
$229.91
|
| Rate for Payer: Nomi Health Commercial |
$394.42
|
| Rate for Payer: PACE SWMI |
$328.68
|
| Rate for Payer: PHP Medicare Advantage |
$328.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$821.60
|
| Rate for Payer: Priority Health HMO/PPO |
$521.59
|
| Rate for Payer: Priority Health Medicare |
$331.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$521.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.68
|
| Rate for Payer: UHC Exchange |
$328.68
|
| Rate for Payer: UHC Medicare Advantage |
$328.68
|
| Rate for Payer: UHCCP Medicaid |
$218.96
|
|
|
PR BIOPSY BONE OPEN SUPERFICIAL
|
Professional
|
Both
|
$546.00
|
|
|
Service Code
|
HCPCS 20240
|
| Min. Negotiated Rate |
$89.46 |
| Max. Negotiated Rate |
$1,002.07 |
| Rate for Payer: Aetna Commercial |
$179.21
|
| Rate for Payer: Aetna Medicare |
$139.09
|
| Rate for Payer: BCBS Complete |
$93.93
|
| Rate for Payer: BCBS MAPPO |
$133.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,002.07
|
| Rate for Payer: BCN Commercial |
$202.32
|
| Rate for Payer: BCN Medicare Advantage |
$133.74
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cofinity Commercial |
$192.59
|
| Rate for Payer: Cofinity Commercial |
$179.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.74
|
| Rate for Payer: Mclaren Medicaid |
$89.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.43
|
| Rate for Payer: Meridian Medicaid |
$93.93
|
| Rate for Payer: Nomi Health Commercial |
$160.49
|
| Rate for Payer: PACE SWMI |
$133.74
|
| Rate for Payer: PHP Medicare Advantage |
$133.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.90
|
| Rate for Payer: Priority Health HMO/PPO |
$212.70
|
| Rate for Payer: Priority Health Medicare |
$135.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$212.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.74
|
| Rate for Payer: UHC Exchange |
$133.74
|
| Rate for Payer: UHC Medicare Advantage |
$133.74
|
| Rate for Payer: UHCCP Medicaid |
$89.46
|
|
|
PR BIOPSY BONE TROCAR/NEEDLE DEEP
|
Professional
|
Both
|
$1,918.00
|
|
|
Service Code
|
HCPCS 20225
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$1,246.70 |
| Rate for Payer: Aetna Commercial |
$164.31
|
| Rate for Payer: Aetna Medicare |
$127.52
|
| Rate for Payer: BCBS Complete |
$86.11
|
| Rate for Payer: BCBS MAPPO |
$122.62
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$567.36
|
| Rate for Payer: BCN Medicare Advantage |
$122.62
|
| Rate for Payer: Cash Price |
$1,534.40
|
| Rate for Payer: Cash Price |
$1,534.40
|
| Rate for Payer: Cofinity Commercial |
$176.57
|
| Rate for Payer: Cofinity Commercial |
$164.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.62
|
| Rate for Payer: Mclaren Medicaid |
$82.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.75
|
| Rate for Payer: Meridian Medicaid |
$86.11
|
| Rate for Payer: Nomi Health Commercial |
$147.14
|
| Rate for Payer: PACE SWMI |
$122.62
|
| Rate for Payer: PHP Medicare Advantage |
$122.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,246.70
|
| Rate for Payer: Priority Health HMO/PPO |
$193.88
|
| Rate for Payer: Priority Health Medicare |
$123.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$193.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.62
|
| Rate for Payer: UHC Exchange |
$122.62
|
| Rate for Payer: UHC Medicare Advantage |
$122.62
|
| Rate for Payer: UHCCP Medicaid |
$82.01
|
|
|
PR BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL
|
Professional
|
Both
|
$348.00
|
|
|
Service Code
|
HCPCS 20220
|
| Min. Negotiated Rate |
$55.17 |
| Max. Negotiated Rate |
$1,002.07 |
| Rate for Payer: Aetna Commercial |
$110.46
|
| Rate for Payer: Aetna Medicare |
$85.73
|
| Rate for Payer: BCBS Complete |
$57.93
|
| Rate for Payer: BCBS MAPPO |
$82.43
|
| Rate for Payer: BCBS Trust/PPO |
$1,002.07
|
| Rate for Payer: BCN Commercial |
$346.47
|
| Rate for Payer: BCN Medicare Advantage |
$82.43
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cofinity Commercial |
$118.70
|
| Rate for Payer: Cofinity Commercial |
$110.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.43
|
| Rate for Payer: Mclaren Medicaid |
$55.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.55
|
| Rate for Payer: Meridian Medicaid |
$57.93
|
| Rate for Payer: Nomi Health Commercial |
$98.92
|
| Rate for Payer: PACE SWMI |
$82.43
|
| Rate for Payer: PHP Medicare Advantage |
$82.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.20
|
| Rate for Payer: Priority Health HMO/PPO |
$130.78
|
| Rate for Payer: Priority Health Medicare |
$83.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$130.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.43
|
| Rate for Payer: UHC Exchange |
$82.43
|
| Rate for Payer: UHC Medicare Advantage |
$82.43
|
| Rate for Payer: UHCCP Medicaid |
$55.17
|
|
|
PR BIOPSY BREAST OPEN INCISIONAL
|
Professional
|
Both
|
$570.00
|
|
|
Service Code
|
HCPCS 19101
|
| Min. Negotiated Rate |
$8.65 |
| Max. Negotiated Rate |
$485.26 |
| Rate for Payer: Aetna Commercial |
$289.65
|
| Rate for Payer: Aetna Medicare |
$224.81
|
| Rate for Payer: BCBS Complete |
$151.86
|
| Rate for Payer: BCBS MAPPO |
$216.16
|
| Rate for Payer: BCBS Trust/PPO |
$8.65
|
| Rate for Payer: BCN Commercial |
$485.26
|
| Rate for Payer: BCN Medicare Advantage |
$216.16
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cofinity Commercial |
$311.27
|
| Rate for Payer: Cofinity Commercial |
$289.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.16
|
| Rate for Payer: Mclaren Medicaid |
$144.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$226.97
|
| Rate for Payer: Meridian Medicaid |
$151.86
|
| Rate for Payer: Nomi Health Commercial |
$259.39
|
| Rate for Payer: PACE SWMI |
$216.16
|
| Rate for Payer: PHP Medicare Advantage |
$216.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$370.50
|
| Rate for Payer: Priority Health HMO/PPO |
$304.33
|
| Rate for Payer: Priority Health Medicare |
$218.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$304.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$216.16
|
| Rate for Payer: UHC Exchange |
$216.16
|
| Rate for Payer: UHC Medicare Advantage |
$216.16
|
| Rate for Payer: UHCCP Medicaid |
$144.63
|
|
|
PR BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
HCPCS 57500
|
| Min. Negotiated Rate |
$48.35 |
| Max. Negotiated Rate |
$225.58 |
| Rate for Payer: Aetna Commercial |
$96.53
|
| Rate for Payer: Aetna Medicare |
$74.92
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCBS MAPPO |
$72.04
|
| Rate for Payer: BCBS Trust/PPO |
$225.58
|
| Rate for Payer: BCN Commercial |
$182.59
|
| Rate for Payer: BCN Medicare Advantage |
$72.04
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cofinity Commercial |
$96.53
|
| Rate for Payer: Cofinity Commercial |
$103.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.04
|
| Rate for Payer: Mclaren Medicaid |
$48.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.64
|
| Rate for Payer: Meridian Medicaid |
$50.77
|
| Rate for Payer: Nomi Health Commercial |
$86.45
|
| Rate for Payer: PACE SWMI |
$72.04
|
| Rate for Payer: PHP Medicare Advantage |
$72.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.70
|
| Rate for Payer: Priority Health HMO/PPO |
$112.11
|
| Rate for Payer: Priority Health Medicare |
$72.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.04
|
| Rate for Payer: UHC Exchange |
$72.04
|
| Rate for Payer: UHC Medicare Advantage |
$72.04
|
| Rate for Payer: UHCCP Medicaid |
$48.35
|
|
|
PR BIOPSY, EACH ADDED LESION
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS 11101
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$44.20 |
| Rate for Payer: Aetna Medicare |
$34.00
|
| Rate for Payer: BCBS Complete |
$27.20
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.20
|
|
|
PR BIOPSY EXTERNAL AUDITORY CANAL
|
Professional
|
Both
|
$239.00
|
|
|
Service Code
|
HCPCS 69105
|
| Min. Negotiated Rate |
$41.75 |
| Max. Negotiated Rate |
$2,308.67 |
| Rate for Payer: Aetna Commercial |
$82.16
|
| Rate for Payer: Aetna Medicare |
$63.76
|
| Rate for Payer: BCBS Complete |
$43.84
|
| Rate for Payer: BCBS MAPPO |
$61.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,308.67
|
| Rate for Payer: BCN Commercial |
$214.53
|
| Rate for Payer: BCN Medicare Advantage |
$61.31
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cofinity Commercial |
$88.29
|
| Rate for Payer: Cofinity Commercial |
$82.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.31
|
| Rate for Payer: Mclaren Medicaid |
$41.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.38
|
| Rate for Payer: Meridian Medicaid |
$43.84
|
| Rate for Payer: Nomi Health Commercial |
$73.57
|
| Rate for Payer: PACE SWMI |
$61.31
|
| Rate for Payer: PHP Medicare Advantage |
$61.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.35
|
| Rate for Payer: Priority Health HMO/PPO |
$93.38
|
| Rate for Payer: Priority Health Medicare |
$61.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.31
|
| Rate for Payer: UHC Exchange |
$61.31
|
| Rate for Payer: UHC Medicare Advantage |
$61.31
|
| Rate for Payer: UHCCP Medicaid |
$41.75
|
|
|
PR BIOPSY EXTERNAL EAR
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
HCPCS 69100
|
| Min. Negotiated Rate |
$29.39 |
| Max. Negotiated Rate |
$1,733.35 |
| Rate for Payer: Aetna Commercial |
$58.53
|
| Rate for Payer: Aetna Medicare |
$45.43
|
| Rate for Payer: BCBS Complete |
$30.86
|
| Rate for Payer: BCBS MAPPO |
$43.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,733.35
|
| Rate for Payer: BCN Commercial |
$141.72
|
| Rate for Payer: BCN Medicare Advantage |
$43.68
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cofinity Commercial |
$62.90
|
| Rate for Payer: Cofinity Commercial |
$58.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.68
|
| Rate for Payer: Mclaren Medicaid |
$29.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.86
|
| Rate for Payer: Meridian Medicaid |
$30.86
|
| Rate for Payer: Nomi Health Commercial |
$52.42
|
| Rate for Payer: PACE SWMI |
$43.68
|
| Rate for Payer: PHP Medicare Advantage |
$43.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.10
|
| Rate for Payer: Priority Health HMO/PPO |
$67.12
|
| Rate for Payer: Priority Health Medicare |
$44.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.68
|
| Rate for Payer: UHC Exchange |
$43.68
|
| Rate for Payer: UHC Medicare Advantage |
$43.68
|
| Rate for Payer: UHCCP Medicaid |
$29.39
|
|
|
PR BIOPSY FLOOR MOUTH
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 41108
|
| Min. Negotiated Rate |
$59.43 |
| Max. Negotiated Rate |
$1,421.66 |
| Rate for Payer: Aetna Commercial |
$116.23
|
| Rate for Payer: Aetna Medicare |
$90.21
|
| Rate for Payer: BCBS Complete |
$62.40
|
| Rate for Payer: BCBS MAPPO |
$86.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,421.66
|
| Rate for Payer: BCN Commercial |
$249.22
|
| Rate for Payer: BCN Medicare Advantage |
$86.74
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$124.91
|
| Rate for Payer: Cofinity Commercial |
$116.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.74
|
| Rate for Payer: Mclaren Medicaid |
$59.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.08
|
| Rate for Payer: Meridian Medicaid |
$62.40
|
| Rate for Payer: Nomi Health Commercial |
$104.09
|
| Rate for Payer: PACE SWMI |
$86.74
|
| Rate for Payer: PHP Medicare Advantage |
$86.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.00
|
| Rate for Payer: Priority Health HMO/PPO |
$164.65
|
| Rate for Payer: Priority Health Medicare |
$87.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.74
|
| Rate for Payer: UHC Exchange |
$86.74
|
| Rate for Payer: UHC Medicare Advantage |
$86.74
|
| Rate for Payer: UHCCP Medicaid |
$59.43
|
|
|
PR BIOPSY HYPOPHARYNX
|
Professional
|
Both
|
$441.00
|
|
|
Service Code
|
HCPCS 42802
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$286.65 |
| Rate for Payer: Aetna Medicare |
$220.50
|
| Rate for Payer: BCBS Complete |
$176.40
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.65
|
|
|
PR BIOPSY INTRANASAL
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 30100
|
| Min. Negotiated Rate |
$44.30 |
| Max. Negotiated Rate |
$591.70 |
| Rate for Payer: Aetna Commercial |
$87.23
|
| Rate for Payer: Aetna Medicare |
$67.70
|
| Rate for Payer: BCBS Complete |
$46.52
|
| Rate for Payer: BCBS MAPPO |
$65.10
|
| Rate for Payer: BCBS Trust/PPO |
$591.70
|
| Rate for Payer: BCN Commercial |
$208.66
|
| Rate for Payer: BCN Medicare Advantage |
$65.10
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$93.74
|
| Rate for Payer: Cofinity Commercial |
$87.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.10
|
| Rate for Payer: Mclaren Medicaid |
$44.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.36
|
| Rate for Payer: Meridian Medicaid |
$46.52
|
| Rate for Payer: Nomi Health Commercial |
$78.12
|
| Rate for Payer: PACE SWMI |
$65.10
|
| Rate for Payer: PHP Medicare Advantage |
$65.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.20
|
| Rate for Payer: Priority Health HMO/PPO |
$95.47
|
| Rate for Payer: Priority Health Medicare |
$65.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.10
|
| Rate for Payer: UHC Exchange |
$65.10
|
| Rate for Payer: UHC Medicare Advantage |
$65.10
|
| Rate for Payer: UHCCP Medicaid |
$44.30
|
|
