|
PR BRIEF CHECK IN BY MD/QHP
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS G2012
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$19.50 |
| Rate for Payer: Aetna Medicare |
$15.00
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
|
|
PR BRIEF COMMUNICATION TECH-BSD SVC EST PT 5-10 MIN
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 98016
|
| Min. Negotiated Rate |
$14.29 |
| Max. Negotiated Rate |
$27.95 |
| Rate for Payer: Aetna Commercial |
$19.15
|
| Rate for Payer: Aetna Medicare |
$14.86
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$14.29
|
| Rate for Payer: BCN Medicare Advantage |
$14.29
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$20.58
|
| Rate for Payer: Cofinity Commercial |
$19.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.00
|
| Rate for Payer: Nomi Health Commercial |
$17.15
|
| Rate for Payer: PACE SWMI |
$14.29
|
| Rate for Payer: PHP Medicare Advantage |
$14.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Medicare |
$14.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.29
|
| Rate for Payer: UHC Exchange |
$14.29
|
| Rate for Payer: UHC Medicare Advantage |
$14.29
|
|
|
PR BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 94060
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$50.80 |
| Rate for Payer: Aetna Commercial |
$47.28
|
| Rate for Payer: Aetna Commercial |
$47.28
|
| Rate for Payer: Aetna Medicare |
$36.69
|
| Rate for Payer: Aetna Medicare |
$36.69
|
| Rate for Payer: BCBS Complete |
$49.20
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: BCBS MAPPO |
$35.28
|
| Rate for Payer: BCBS MAPPO |
$35.28
|
| Rate for Payer: BCN Medicare Advantage |
$35.28
|
| Rate for Payer: BCN Medicare Advantage |
$35.28
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$50.80
|
| Rate for Payer: Cofinity Commercial |
$47.28
|
| Rate for Payer: Cofinity Commercial |
$50.80
|
| Rate for Payer: Cofinity Commercial |
$47.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.04
|
| Rate for Payer: Nomi Health Commercial |
$42.34
|
| Rate for Payer: Nomi Health Commercial |
$42.34
|
| Rate for Payer: PACE SWMI |
$35.28
|
| Rate for Payer: PACE SWMI |
$35.28
|
| Rate for Payer: PHP Medicare Advantage |
$35.28
|
| Rate for Payer: PHP Medicare Advantage |
$35.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health Medicare |
$35.63
|
| Rate for Payer: Priority Health Medicare |
$35.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.28
|
| Rate for Payer: UHC Exchange |
$35.28
|
| Rate for Payer: UHC Exchange |
$35.28
|
| Rate for Payer: UHC Medicare Advantage |
$35.28
|
| Rate for Payer: UHC Medicare Advantage |
$35.28
|
|
|
PR BRNCHSC BRUSHING/PROTECTED BRUSHINGS
|
Professional
|
Both
|
$649.00
|
|
|
Service Code
|
HCPCS 31623
|
| Min. Negotiated Rate |
$123.86 |
| Max. Negotiated Rate |
$421.85 |
| Rate for Payer: Aetna Commercial |
$165.97
|
| Rate for Payer: Aetna Medicare |
$128.81
|
| Rate for Payer: BCBS Complete |
$259.60
|
| Rate for Payer: BCBS MAPPO |
$123.86
|
| Rate for Payer: BCN Medicare Advantage |
$123.86
|
| Rate for Payer: Cash Price |
$519.20
|
| Rate for Payer: Cash Price |
$519.20
|
| Rate for Payer: Cofinity Commercial |
$178.36
|
| Rate for Payer: Cofinity Commercial |
$165.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.05
|
| Rate for Payer: Nomi Health Commercial |
$148.63
|
| Rate for Payer: PACE SWMI |
$123.86
|
| Rate for Payer: PHP Medicare Advantage |
$123.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.85
|
| Rate for Payer: Priority Health Medicare |
$125.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.86
|
| Rate for Payer: UHC Exchange |
$123.86
|
| Rate for Payer: UHC Medicare Advantage |
$123.86
|
|
|
PR BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX
|
Professional
|
Both
|
$482.00
|
|
|
Service Code
|
HCPCS 31652
|
| Min. Negotiated Rate |
$192.80 |
| Max. Negotiated Rate |
$313.30 |
| Rate for Payer: Aetna Commercial |
$277.96
|
| Rate for Payer: Aetna Medicare |
$215.73
|
| Rate for Payer: BCBS Complete |
$192.80
|
| Rate for Payer: BCBS MAPPO |
$207.43
|
| Rate for Payer: BCN Medicare Advantage |
$207.43
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cash Price |
$385.60
|
| Rate for Payer: Cofinity Commercial |
$298.70
|
| Rate for Payer: Cofinity Commercial |
$277.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$217.80
|
| Rate for Payer: Nomi Health Commercial |
$248.92
|
| Rate for Payer: PACE SWMI |
$207.43
|
| Rate for Payer: PHP Medicare Advantage |
$207.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.30
|
| Rate for Payer: Priority Health Medicare |
$209.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$207.43
|
| Rate for Payer: UHC Exchange |
$207.43
|
| Rate for Payer: UHC Medicare Advantage |
$207.43
|
|
|
PR BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX
|
Professional
|
Both
|
$532.00
|
|
|
Service Code
|
HCPCS 31653
|
| Min. Negotiated Rate |
$212.80 |
| Max. Negotiated Rate |
$345.80 |
| Rate for Payer: Aetna Commercial |
$308.21
|
| Rate for Payer: Aetna Medicare |
$239.21
|
| Rate for Payer: BCBS Complete |
$212.80
|
| Rate for Payer: BCBS MAPPO |
$230.01
|
| Rate for Payer: BCN Medicare Advantage |
$230.01
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cofinity Commercial |
$331.21
|
| Rate for Payer: Cofinity Commercial |
$308.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.51
|
| Rate for Payer: Nomi Health Commercial |
$276.01
|
| Rate for Payer: PACE SWMI |
$230.01
|
| Rate for Payer: PHP Medicare Advantage |
$230.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.80
|
| Rate for Payer: Priority Health Medicare |
$232.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$230.01
|
| Rate for Payer: UHC Exchange |
$230.01
|
| Rate for Payer: UHC Medicare Advantage |
$230.01
|
|
|
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX
|
Professional
|
Both
|
$596.00
|
|
|
Service Code
|
HCPCS 31622
|
| Min. Negotiated Rate |
$124.67 |
| Max. Negotiated Rate |
$387.40 |
| Rate for Payer: Aetna Commercial |
$167.06
|
| Rate for Payer: Aetna Medicare |
$129.66
|
| Rate for Payer: BCBS Complete |
$238.40
|
| Rate for Payer: BCBS MAPPO |
$124.67
|
| Rate for Payer: BCN Medicare Advantage |
$124.67
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cash Price |
$476.80
|
| Rate for Payer: Cofinity Commercial |
$179.52
|
| Rate for Payer: Cofinity Commercial |
$167.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.90
|
| Rate for Payer: Nomi Health Commercial |
$149.60
|
| Rate for Payer: PACE SWMI |
$124.67
|
| Rate for Payer: PHP Medicare Advantage |
$124.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.40
|
| Rate for Payer: Priority Health Medicare |
$125.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.67
|
| Rate for Payer: UHC Exchange |
$124.67
|
| Rate for Payer: UHC Medicare Advantage |
$124.67
|
|
|
PR BRNCHSC W/BRNCL ALVEOLAR LAVAGE
|
Professional
|
Both
|
$605.00
|
|
|
Service Code
|
HCPCS 31624
|
| Min. Negotiated Rate |
$125.71 |
| Max. Negotiated Rate |
$393.25 |
| Rate for Payer: Aetna Commercial |
$168.45
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: BCBS Complete |
$242.00
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$484.00
|
| Rate for Payer: Cash Price |
$484.00
|
| Rate for Payer: Cofinity Commercial |
$181.02
|
| Rate for Payer: Cofinity Commercial |
$168.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Nomi Health Commercial |
$150.85
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$393.25
|
| Rate for Payer: Priority Health Medicare |
$126.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$125.71
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
|
|
PR BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 31630
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$269.77 |
| Rate for Payer: Aetna Commercial |
$251.04
|
| Rate for Payer: Aetna Medicare |
$194.83
|
| Rate for Payer: BCBS Complete |
$150.80
|
| Rate for Payer: BCBS MAPPO |
$187.34
|
| Rate for Payer: BCN Medicare Advantage |
$187.34
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cofinity Commercial |
$269.77
|
| Rate for Payer: Cofinity Commercial |
$251.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$196.71
|
| Rate for Payer: Nomi Health Commercial |
$224.81
|
| Rate for Payer: PACE SWMI |
$187.34
|
| Rate for Payer: PHP Medicare Advantage |
$187.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.05
|
| Rate for Payer: Priority Health Medicare |
$189.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$187.34
|
| Rate for Payer: UHC Exchange |
$187.34
|
| Rate for Payer: UHC Medicare Advantage |
$187.34
|
|
|
PR BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT
|
Professional
|
Both
|
$138.00
|
|
|
Service Code
|
HCPCS 94070
|
| Min. Negotiated Rate |
$55.20 |
| Max. Negotiated Rate |
$89.70 |
| Rate for Payer: Aetna Commercial |
$77.79
|
| Rate for Payer: Aetna Commercial |
$77.79
|
| Rate for Payer: Aetna Medicare |
$60.37
|
| Rate for Payer: Aetna Medicare |
$60.37
|
| Rate for Payer: BCBS Complete |
$55.20
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS MAPPO |
$58.05
|
| Rate for Payer: BCBS MAPPO |
$58.05
|
| Rate for Payer: BCN Medicare Advantage |
$58.05
|
| Rate for Payer: BCN Medicare Advantage |
$58.05
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cofinity Commercial |
$83.59
|
| Rate for Payer: Cofinity Commercial |
$77.79
|
| Rate for Payer: Cofinity Commercial |
$83.59
|
| Rate for Payer: Cofinity Commercial |
$77.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.95
|
| Rate for Payer: Nomi Health Commercial |
$69.66
|
| Rate for Payer: Nomi Health Commercial |
$69.66
|
| Rate for Payer: PACE SWMI |
$58.05
|
| Rate for Payer: PACE SWMI |
$58.05
|
| Rate for Payer: PHP Medicare Advantage |
$58.05
|
| Rate for Payer: PHP Medicare Advantage |
$58.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health Medicare |
$58.63
|
| Rate for Payer: Priority Health Medicare |
$58.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.05
|
| Rate for Payer: UHC Exchange |
$58.05
|
| Rate for Payer: UHC Exchange |
$58.05
|
| Rate for Payer: UHC Medicare Advantage |
$58.05
|
| Rate for Payer: UHC Medicare Advantage |
$58.05
|
|
|
PR BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 31654
|
| Min. Negotiated Rate |
$62.89 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna Commercial |
$84.27
|
| Rate for Payer: Aetna Medicare |
$65.41
|
| Rate for Payer: BCBS Complete |
$86.40
|
| Rate for Payer: BCBS MAPPO |
$62.89
|
| Rate for Payer: BCN Medicare Advantage |
$62.89
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$90.56
|
| Rate for Payer: Cofinity Commercial |
$84.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.03
|
| Rate for Payer: Nomi Health Commercial |
$75.47
|
| Rate for Payer: PACE SWMI |
$62.89
|
| Rate for Payer: PHP Medicare Advantage |
$62.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.40
|
| Rate for Payer: Priority Health Medicare |
$63.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.89
|
| Rate for Payer: UHC Exchange |
$62.89
|
| Rate for Payer: UHC Medicare Advantage |
$62.89
|
|
|
PR BRONCHOPLASTY GRAFT REPAIR
|
Professional
|
Both
|
$2,953.00
|
|
|
Service Code
|
HCPCS 31770
|
| Min. Negotiated Rate |
$1,181.20 |
| Max. Negotiated Rate |
$1,919.45 |
| Rate for Payer: Aetna Commercial |
$1,710.70
|
| Rate for Payer: Aetna Medicare |
$1,327.71
|
| Rate for Payer: BCBS Complete |
$1,181.20
|
| Rate for Payer: BCBS MAPPO |
$1,276.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,276.64
|
| Rate for Payer: Cash Price |
$2,362.40
|
| Rate for Payer: Cash Price |
$2,362.40
|
| Rate for Payer: Cofinity Commercial |
$1,838.36
|
| Rate for Payer: Cofinity Commercial |
$1,710.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,276.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,340.47
|
| Rate for Payer: Nomi Health Commercial |
$1,531.97
|
| Rate for Payer: PACE SWMI |
$1,276.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,276.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,919.45
|
| Rate for Payer: Priority Health Medicare |
$1,289.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,276.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,276.64
|
| Rate for Payer: UHC Exchange |
$1,276.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,276.64
|
|
|
PR BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES
|
Professional
|
Both
|
$648.00
|
|
|
Service Code
|
HCPCS 31625
|
| Min. Negotiated Rate |
$146.37 |
| Max. Negotiated Rate |
$421.20 |
| Rate for Payer: Aetna Commercial |
$196.14
|
| Rate for Payer: Aetna Medicare |
$152.22
|
| Rate for Payer: BCBS Complete |
$259.20
|
| Rate for Payer: BCBS MAPPO |
$146.37
|
| Rate for Payer: BCN Medicare Advantage |
$146.37
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cofinity Commercial |
$210.77
|
| Rate for Payer: Cofinity Commercial |
$196.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.69
|
| Rate for Payer: Nomi Health Commercial |
$175.64
|
| Rate for Payer: PACE SWMI |
$146.37
|
| Rate for Payer: PHP Medicare Advantage |
$146.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.20
|
| Rate for Payer: Priority Health Medicare |
$147.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.37
|
| Rate for Payer: UHC Exchange |
$146.37
|
| Rate for Payer: UHC Medicare Advantage |
$146.37
|
|
|
PR BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON
|
Professional
|
Both
|
$1,259.00
|
|
|
Service Code
|
HCPCS 31629
|
| Min. Negotiated Rate |
$175.62 |
| Max. Negotiated Rate |
$818.35 |
| Rate for Payer: Aetna Commercial |
$235.33
|
| Rate for Payer: Aetna Medicare |
$182.64
|
| Rate for Payer: BCBS Complete |
$503.60
|
| Rate for Payer: BCBS MAPPO |
$175.62
|
| Rate for Payer: BCN Medicare Advantage |
$175.62
|
| Rate for Payer: Cash Price |
$1,007.20
|
| Rate for Payer: Cash Price |
$1,007.20
|
| Rate for Payer: Cofinity Commercial |
$252.89
|
| Rate for Payer: Cofinity Commercial |
$235.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.40
|
| Rate for Payer: Nomi Health Commercial |
$210.74
|
| Rate for Payer: PACE SWMI |
$175.62
|
| Rate for Payer: PHP Medicare Advantage |
$175.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$818.35
|
| Rate for Payer: Priority Health Medicare |
$177.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.62
|
| Rate for Payer: UHC Exchange |
$175.62
|
| Rate for Payer: UHC Medicare Advantage |
$175.62
|
|
|
PR BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
HCPCS 31627
|
| Min. Negotiated Rate |
$69.20 |
| Max. Negotiated Rate |
$130.39 |
| Rate for Payer: Aetna Commercial |
$121.34
|
| Rate for Payer: Aetna Medicare |
$94.17
|
| Rate for Payer: BCBS Complete |
$69.20
|
| Rate for Payer: BCBS MAPPO |
$90.55
|
| Rate for Payer: BCN Medicare Advantage |
$90.55
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cofinity Commercial |
$130.39
|
| Rate for Payer: Cofinity Commercial |
$121.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.08
|
| Rate for Payer: Nomi Health Commercial |
$108.66
|
| Rate for Payer: PACE SWMI |
$90.55
|
| Rate for Payer: PHP Medicare Advantage |
$90.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.45
|
| Rate for Payer: Priority Health Medicare |
$91.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.55
|
| Rate for Payer: UHC Exchange |
$90.55
|
| Rate for Payer: UHC Medicare Advantage |
$90.55
|
|
|
PR BRONCHOSCOPY W/EXCISION TUMOR
|
Professional
|
Both
|
$521.00
|
|
|
Service Code
|
HCPCS 31640
|
| Min. Negotiated Rate |
$208.40 |
| Max. Negotiated Rate |
$338.65 |
| Rate for Payer: Aetna Commercial |
$310.36
|
| Rate for Payer: Aetna Medicare |
$240.87
|
| Rate for Payer: BCBS Complete |
$208.40
|
| Rate for Payer: BCBS MAPPO |
$231.61
|
| Rate for Payer: BCN Medicare Advantage |
$231.61
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cofinity Commercial |
$333.52
|
| Rate for Payer: Cofinity Commercial |
$310.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$243.19
|
| Rate for Payer: Nomi Health Commercial |
$277.93
|
| Rate for Payer: PACE SWMI |
$231.61
|
| Rate for Payer: PHP Medicare Advantage |
$231.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.65
|
| Rate for Payer: Priority Health Medicare |
$233.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$231.61
|
| Rate for Payer: UHC Exchange |
$231.61
|
| Rate for Payer: UHC Medicare Advantage |
$231.61
|
|
|
PR BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 31631
|
| Min. Negotiated Rate |
$213.42 |
| Max. Negotiated Rate |
$497.25 |
| Rate for Payer: Aetna Commercial |
$285.98
|
| Rate for Payer: Aetna Medicare |
$221.96
|
| Rate for Payer: BCBS Complete |
$306.00
|
| Rate for Payer: BCBS MAPPO |
$213.42
|
| Rate for Payer: BCN Medicare Advantage |
$213.42
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$307.32
|
| Rate for Payer: Cofinity Commercial |
$285.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$224.09
|
| Rate for Payer: Nomi Health Commercial |
$256.10
|
| Rate for Payer: PACE SWMI |
$213.42
|
| Rate for Payer: PHP Medicare Advantage |
$213.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.25
|
| Rate for Payer: Priority Health Medicare |
$215.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$213.42
|
| Rate for Payer: UHC Exchange |
$213.42
|
| Rate for Payer: UHC Medicare Advantage |
$213.42
|
|
|
PR BRONCHOSCOPY W/REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,137.00
|
|
|
Service Code
|
HCPCS 31635
|
| Min. Negotiated Rate |
$164.95 |
| Max. Negotiated Rate |
$739.05 |
| Rate for Payer: Aetna Commercial |
$221.03
|
| Rate for Payer: Aetna Medicare |
$171.55
|
| Rate for Payer: BCBS Complete |
$454.80
|
| Rate for Payer: BCBS MAPPO |
$164.95
|
| Rate for Payer: BCN Medicare Advantage |
$164.95
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cash Price |
$909.60
|
| Rate for Payer: Cofinity Commercial |
$237.53
|
| Rate for Payer: Cofinity Commercial |
$221.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.20
|
| Rate for Payer: Nomi Health Commercial |
$197.94
|
| Rate for Payer: PACE SWMI |
$164.95
|
| Rate for Payer: PHP Medicare Advantage |
$164.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$739.05
|
| Rate for Payer: Priority Health Medicare |
$166.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.95
|
| Rate for Payer: UHC Exchange |
$164.95
|
| Rate for Payer: UHC Medicare Advantage |
$164.95
|
|
|
PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST
|
Professional
|
Both
|
$689.00
|
|
|
Service Code
|
HCPCS 31645
|
| Min. Negotiated Rate |
$138.26 |
| Max. Negotiated Rate |
$447.85 |
| Rate for Payer: Aetna Commercial |
$185.27
|
| Rate for Payer: Aetna Medicare |
$143.79
|
| Rate for Payer: BCBS Complete |
$275.60
|
| Rate for Payer: BCBS MAPPO |
$138.26
|
| Rate for Payer: BCN Medicare Advantage |
$138.26
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Cash Price |
$551.20
|
| Rate for Payer: Cofinity Commercial |
$199.09
|
| Rate for Payer: Cofinity Commercial |
$185.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.17
|
| Rate for Payer: Nomi Health Commercial |
$165.91
|
| Rate for Payer: PACE SWMI |
$138.26
|
| Rate for Payer: PHP Medicare Advantage |
$138.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.85
|
| Rate for Payer: Priority Health Medicare |
$139.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.26
|
| Rate for Payer: UHC Exchange |
$138.26
|
| Rate for Payer: UHC Medicare Advantage |
$138.26
|
|
|
PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 31646
|
| Min. Negotiated Rate |
$134.06 |
| Max. Negotiated Rate |
$399.10 |
| Rate for Payer: Aetna Commercial |
$179.64
|
| Rate for Payer: Aetna Medicare |
$139.42
|
| Rate for Payer: BCBS Complete |
$245.60
|
| Rate for Payer: BCBS MAPPO |
$134.06
|
| Rate for Payer: BCN Medicare Advantage |
$134.06
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Commercial |
$193.05
|
| Rate for Payer: Cofinity Commercial |
$179.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.76
|
| Rate for Payer: Nomi Health Commercial |
$160.87
|
| Rate for Payer: PACE SWMI |
$134.06
|
| Rate for Payer: PHP Medicare Advantage |
$134.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.10
|
| Rate for Payer: Priority Health Medicare |
$135.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.06
|
| Rate for Payer: UHC Exchange |
$134.06
|
| Rate for Payer: UHC Medicare Advantage |
$134.06
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE
|
Professional
|
Both
|
$760.00
|
|
|
Service Code
|
HCPCS 31628
|
| Min. Negotiated Rate |
$164.44 |
| Max. Negotiated Rate |
$494.00 |
| Rate for Payer: Aetna Commercial |
$220.35
|
| Rate for Payer: Aetna Medicare |
$171.02
|
| Rate for Payer: BCBS Complete |
$304.00
|
| Rate for Payer: BCBS MAPPO |
$164.44
|
| Rate for Payer: BCN Medicare Advantage |
$164.44
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cash Price |
$608.00
|
| Rate for Payer: Cofinity Commercial |
$236.79
|
| Rate for Payer: Cofinity Commercial |
$220.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.66
|
| Rate for Payer: Nomi Health Commercial |
$197.33
|
| Rate for Payer: PACE SWMI |
$164.44
|
| Rate for Payer: PHP Medicare Advantage |
$164.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.00
|
| Rate for Payer: Priority Health Medicare |
$166.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.44
|
| Rate for Payer: UHC Exchange |
$164.44
|
| Rate for Payer: UHC Medicare Advantage |
$164.44
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 31632
|
| Min. Negotiated Rate |
$45.49 |
| Max. Negotiated Rate |
$83.85 |
| Rate for Payer: Aetna Commercial |
$60.96
|
| Rate for Payer: Aetna Medicare |
$47.31
|
| Rate for Payer: BCBS Complete |
$51.60
|
| Rate for Payer: BCBS MAPPO |
$45.49
|
| Rate for Payer: BCN Medicare Advantage |
$45.49
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$65.51
|
| Rate for Payer: Cofinity Commercial |
$60.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.76
|
| Rate for Payer: Nomi Health Commercial |
$54.59
|
| Rate for Payer: PACE SWMI |
$45.49
|
| Rate for Payer: PHP Medicare Advantage |
$45.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.85
|
| Rate for Payer: Priority Health Medicare |
$45.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.49
|
| Rate for Payer: UHC Exchange |
$45.49
|
| Rate for Payer: UHC Medicare Advantage |
$45.49
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
HCPCS 31633
|
| Min. Negotiated Rate |
$39.60 |
| Max. Negotiated Rate |
$85.56 |
| Rate for Payer: Aetna Commercial |
$79.62
|
| Rate for Payer: Aetna Medicare |
$61.80
|
| Rate for Payer: BCBS Complete |
$39.60
|
| Rate for Payer: BCBS MAPPO |
$59.42
|
| Rate for Payer: BCN Medicare Advantage |
$59.42
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$85.56
|
| Rate for Payer: Cofinity Commercial |
$79.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.39
|
| Rate for Payer: Nomi Health Commercial |
$71.30
|
| Rate for Payer: PACE SWMI |
$59.42
|
| Rate for Payer: PHP Medicare Advantage |
$59.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.35
|
| Rate for Payer: Priority Health Medicare |
$60.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.42
|
| Rate for Payer: UHC Exchange |
$59.42
|
| Rate for Payer: UHC Medicare Advantage |
$59.42
|
|
|
PR BROWLIFT
|
Professional
|
Both
|
$2,652.00
|
|
|
Service Code
|
HCPCS 00532
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,060.80 |
| Max. Negotiated Rate |
$1,723.80 |
| Rate for Payer: Aetna Medicare |
$1,326.00
|
| Rate for Payer: BCBS Complete |
$1,060.80
|
| Rate for Payer: Cash Price |
$2,121.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,723.80
|
|
|
PR BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY
|
Professional
|
Both
|
$5,993.00
|
|
|
Service Code
|
HCPCS 58954
|
| Min. Negotiated Rate |
$2,083.85 |
| Max. Negotiated Rate |
$3,895.45 |
| Rate for Payer: Aetna Commercial |
$2,792.36
|
| Rate for Payer: Aetna Medicare |
$2,167.20
|
| Rate for Payer: BCBS Complete |
$2,397.20
|
| Rate for Payer: BCBS MAPPO |
$2,083.85
|
| Rate for Payer: BCN Medicare Advantage |
$2,083.85
|
| Rate for Payer: Cash Price |
$4,794.40
|
| Rate for Payer: Cash Price |
$4,794.40
|
| Rate for Payer: Cofinity Commercial |
$3,000.74
|
| Rate for Payer: Cofinity Commercial |
$2,792.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,083.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,188.04
|
| Rate for Payer: Nomi Health Commercial |
$2,500.62
|
| Rate for Payer: PACE SWMI |
$2,083.85
|
| Rate for Payer: PHP Medicare Advantage |
$2,083.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,895.45
|
| Rate for Payer: Priority Health Medicare |
$2,104.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,083.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,083.85
|
| Rate for Payer: UHC Exchange |
$2,083.85
|
| Rate for Payer: UHC Medicare Advantage |
$2,083.85
|
|
