|
PR MASTOPEXY
|
Professional
|
Both
|
$1,900.00
|
|
|
Service Code
|
HCPCS 19316
|
| Min. Negotiated Rate |
$293.06 |
| Max. Negotiated Rate |
$1,330.00 |
| Rate for Payer: Aetna Commercial |
$1,042.51
|
| Rate for Payer: Aetna Medicare |
$809.11
|
| Rate for Payer: BCBS Complete |
$533.63
|
| Rate for Payer: BCBS MAPPO |
$777.99
|
| Rate for Payer: BCBS Trust/PPO |
$293.06
|
| Rate for Payer: BCN Commercial |
$1,159.64
|
| Rate for Payer: BCN Medicare Advantage |
$777.99
|
| Rate for Payer: Cash Price |
$1,520.00
|
| Rate for Payer: Cash Price |
$1,520.00
|
| Rate for Payer: Cofinity Commercial |
$1,120.31
|
| Rate for Payer: Cofinity Commercial |
$1,042.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$777.99
|
| Rate for Payer: Mclaren Medicaid |
$508.22
|
| Rate for Payer: Meridian Medicaid |
$533.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$816.89
|
| Rate for Payer: PACE SWMI |
$777.99
|
| Rate for Payer: PHP Medicare Advantage |
$777.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,330.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$975.39
|
| Rate for Payer: Priority Health Medicare |
$777.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$975.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$777.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$777.99
|
| Rate for Payer: UHC Medicare Advantage |
$801.33
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Professional
|
Both
|
$798.00
|
|
|
Service Code
|
HCPCS 19020
|
| Hospital Charge Code |
19020
|
| Min. Negotiated Rate |
$202.78 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$411.82
|
| Rate for Payer: Aetna Medicare |
$319.62
|
| Rate for Payer: BCBS Complete |
$212.92
|
| Rate for Payer: BCBS MAPPO |
$307.33
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$692.46
|
| Rate for Payer: BCN Medicare Advantage |
$307.33
|
| Rate for Payer: Cash Price |
$638.40
|
| Rate for Payer: Cash Price |
$638.40
|
| Rate for Payer: Cofinity Commercial |
$411.82
|
| Rate for Payer: Cofinity Commercial |
$442.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.33
|
| Rate for Payer: Mclaren Medicaid |
$202.78
|
| Rate for Payer: Meridian Medicaid |
$212.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$322.70
|
| Rate for Payer: PACE SWMI |
$307.33
|
| Rate for Payer: PHP Medicare Advantage |
$307.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$558.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$387.20
|
| Rate for Payer: Priority Health Medicare |
$307.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$387.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$307.33
|
| Rate for Payer: UHC Medicare Advantage |
$316.55
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Facility
|
IP
|
$798.00
|
|
|
Service Code
|
CPT 19020
|
| Hospital Charge Code |
19020
|
| Min. Negotiated Rate |
$486.70 |
| Max. Negotiated Rate |
$718.20 |
| Rate for Payer: Aetna Commercial |
$678.30
|
| Rate for Payer: BCBS Trust/PPO |
$616.69
|
| Rate for Payer: BCN Commercial |
$616.69
|
| Rate for Payer: Cash Price |
$638.40
|
| Rate for Payer: Cofinity Commercial |
$686.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$638.40
|
| Rate for Payer: Healthscope Commercial |
$718.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$598.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$678.30
|
| Rate for Payer: PHP Commercial |
$678.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$558.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$694.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$486.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$702.24
|
| Rate for Payer: UHC Core |
$666.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$598.50
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Facility
|
OP
|
$798.00
|
|
|
Service Code
|
CPT 19020
|
| Hospital Charge Code |
19020
|
| Min. Negotiated Rate |
$189.52 |
| Max. Negotiated Rate |
$1,116.73 |
| Rate for Payer: Aetna Commercial |
$678.30
|
| Rate for Payer: Aetna Medicare |
$207.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.38
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$199.50
|
| Rate for Payer: BCBS Trust/PPO |
$620.44
|
| Rate for Payer: BCN Commercial |
$620.44
|
| Rate for Payer: BCN Medicare Advantage |
$199.50
|
| Rate for Payer: Cash Price |
$638.40
|
| Rate for Payer: Cash Price |
$638.40
|
| Rate for Payer: Cofinity Commercial |
$686.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$638.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.50
|
| Rate for Payer: Healthscope Commercial |
$718.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$598.50
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$209.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$678.30
|
| Rate for Payer: PACE Senior Care Partners |
$189.52
|
| Rate for Payer: PACE SWMI |
$199.50
|
| Rate for Payer: PHP Commercial |
$678.30
|
| Rate for Payer: PHP Medicare Advantage |
$199.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$558.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$694.26
|
| Rate for Payer: Priority Health Medicare |
$199.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$486.70
|
| Rate for Payer: Railroad Medicare Medicare |
$199.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$702.24
|
| Rate for Payer: UHC Core |
$666.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$199.50
|
| Rate for Payer: UHC Medicare Advantage |
$205.48
|
| Rate for Payer: VA VA |
$199.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$598.50
|
|
|
PR MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP
|
Professional
|
Both
|
$798.00
|
|
|
Service Code
|
HCPCS 19020
|
| Min. Negotiated Rate |
$202.78 |
| Max. Negotiated Rate |
$6,614.63 |
| Rate for Payer: Aetna Commercial |
$411.82
|
| Rate for Payer: Aetna Medicare |
$319.62
|
| Rate for Payer: BCBS Complete |
$212.92
|
| Rate for Payer: BCBS MAPPO |
$307.33
|
| Rate for Payer: BCBS Trust/PPO |
$6,614.63
|
| Rate for Payer: BCN Commercial |
$692.46
|
| Rate for Payer: BCN Medicare Advantage |
$307.33
|
| Rate for Payer: Cash Price |
$638.40
|
| Rate for Payer: Cash Price |
$638.40
|
| Rate for Payer: Cofinity Commercial |
$411.82
|
| Rate for Payer: Cofinity Commercial |
$442.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.33
|
| Rate for Payer: Mclaren Medicaid |
$202.78
|
| Rate for Payer: Meridian Medicaid |
$212.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$322.70
|
| Rate for Payer: PACE SWMI |
$307.33
|
| Rate for Payer: PHP Medicare Advantage |
$307.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$202.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$558.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$387.20
|
| Rate for Payer: Priority Health Medicare |
$307.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$387.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$307.33
|
| Rate for Payer: UHC Medicare Advantage |
$316.55
|
|
|
PR MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES
|
Professional
|
Both
|
$2,369.00
|
|
|
Service Code
|
HCPCS 19305
|
| Min. Negotiated Rate |
$737.62 |
| Max. Negotiated Rate |
$2,189.70 |
| Rate for Payer: Aetna Commercial |
$1,529.96
|
| Rate for Payer: Aetna Medicare |
$1,187.43
|
| Rate for Payer: BCBS Complete |
$774.50
|
| Rate for Payer: BCBS MAPPO |
$1,141.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.70
|
| Rate for Payer: BCN Commercial |
$1,685.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,141.76
|
| Rate for Payer: Cash Price |
$1,895.20
|
| Rate for Payer: Cash Price |
$1,895.20
|
| Rate for Payer: Cofinity Commercial |
$1,644.13
|
| Rate for Payer: Cofinity Commercial |
$1,529.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,141.76
|
| Rate for Payer: Mclaren Medicaid |
$737.62
|
| Rate for Payer: Meridian Medicaid |
$774.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,198.85
|
| Rate for Payer: PACE SWMI |
$1,141.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,141.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$737.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,658.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,418.09
|
| Rate for Payer: Priority Health Medicare |
$1,141.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,418.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,141.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,141.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,176.01
|
|
|
PR MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 94200
|
| Min. Negotiated Rate |
$13.85 |
| Max. Negotiated Rate |
$2,544.29 |
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: Aetna Medicare |
$14.40
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$13.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,544.29
|
| Rate for Payer: BCN Commercial |
$21.51
|
| Rate for Payer: BCN Medicare Advantage |
$13.85
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$18.56
|
| Rate for Payer: Cofinity Commercial |
$19.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.54
|
| Rate for Payer: PACE SWMI |
$13.85
|
| Rate for Payer: PHP Medicare Advantage |
$13.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.76
|
| Rate for Payer: Priority Health Medicare |
$13.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.85
|
| Rate for Payer: UHC Medicare Advantage |
$14.27
|
|
|
PR MAXILLECTOMY W/O ORBITAL EXENTERATION
|
Professional
|
Both
|
$3,239.00
|
|
|
Service Code
|
HCPCS 31225
|
| Min. Negotiated Rate |
$904.98 |
| Max. Negotiated Rate |
$2,643.74 |
| Rate for Payer: Aetna Commercial |
$2,374.13
|
| Rate for Payer: Aetna Medicare |
$1,842.61
|
| Rate for Payer: BCBS Complete |
$1,209.27
|
| Rate for Payer: BCBS MAPPO |
$1,771.74
|
| Rate for Payer: BCBS Trust/PPO |
$904.98
|
| Rate for Payer: BCN Commercial |
$2,643.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,771.74
|
| Rate for Payer: Cash Price |
$2,591.20
|
| Rate for Payer: Cash Price |
$2,591.20
|
| Rate for Payer: Cofinity Commercial |
$2,374.13
|
| Rate for Payer: Cofinity Commercial |
$2,551.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,771.74
|
| Rate for Payer: Mclaren Medicaid |
$1,151.69
|
| Rate for Payer: Meridian Medicaid |
$1,209.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,860.33
|
| Rate for Payer: PACE SWMI |
$1,771.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,771.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,151.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,267.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,505.08
|
| Rate for Payer: Priority Health Medicare |
$1,771.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,505.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,771.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,771.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,824.89
|
|
|
PR MCCD, INITIAL RATE
|
Professional
|
Both
|
$160.00
|
|
|
Service Code
|
HCPCS G9001
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1,218.26 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,218.26
|
| Rate for Payer: BCN Commercial |
$136.23
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.00
|
|
|
PR MCCD,MAINTENANCE RATE
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS G9002
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$884.37 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Complete |
$32.00
|
| Rate for Payer: BCBS Trust/PPO |
$884.37
|
| Rate for Payer: BCN Commercial |
$68.13
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
|
|
PR MCCD,PHYS COOR-CARE OVRSGHT
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS G9008
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1,823.69 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,823.69
|
| Rate for Payer: BCN Commercial |
$50.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.50
|
|
|
PR MCCD, SCH TEAM CONF
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS G9007
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1,852.75 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,852.75
|
| Rate for Payer: BCN Commercial |
$28.81
|
| 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 MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 36596
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$745.43 |
| Rate for Payer: Aetna Commercial |
$57.55
|
| Rate for Payer: Aetna Medicare |
$44.67
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS MAPPO |
$42.95
|
| Rate for Payer: BCBS Trust/PPO |
$745.43
|
| Rate for Payer: BCN Commercial |
$167.13
|
| Rate for Payer: BCN Medicare Advantage |
$42.95
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$61.85
|
| Rate for Payer: Cofinity Commercial |
$57.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.95
|
| Rate for Payer: Mclaren Medicaid |
$28.33
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.10
|
| Rate for Payer: PACE SWMI |
$42.95
|
| Rate for Payer: PHP Medicare Advantage |
$42.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.15
|
| Rate for Payer: Priority Health Medicare |
$42.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.95
|
| Rate for Payer: UHC Medicare Advantage |
$44.24
|
|
|
PR MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS
|
Professional
|
Both
|
$1,120.00
|
|
|
Service Code
|
HCPCS 36595
|
| Min. Negotiated Rate |
$112.68 |
| Max. Negotiated Rate |
$871.31 |
| Rate for Payer: Aetna Commercial |
$236.48
|
| Rate for Payer: Aetna Medicare |
$183.54
|
| Rate for Payer: BCBS Complete |
$118.31
|
| Rate for Payer: BCBS MAPPO |
$176.48
|
| Rate for Payer: BCBS Trust/PPO |
$586.94
|
| Rate for Payer: BCN Commercial |
$871.31
|
| Rate for Payer: BCN Medicare Advantage |
$176.48
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cofinity Commercial |
$254.13
|
| Rate for Payer: Cofinity Commercial |
$236.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.48
|
| Rate for Payer: Mclaren Medicaid |
$112.68
|
| Rate for Payer: Meridian Medicaid |
$118.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$185.30
|
| Rate for Payer: PACE SWMI |
$176.48
|
| Rate for Payer: PHP Medicare Advantage |
$176.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$784.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$281.40
|
| Rate for Payer: Priority Health Medicare |
$176.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$281.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.48
|
| Rate for Payer: UHC Medicare Advantage |
$181.77
|
|
|
PR MD CERTIFICATION HHA PATIENT
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS G0180
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$76.60 |
| Rate for Payer: Aetna Commercial |
$67.12
|
| Rate for Payer: Aetna Medicare |
$52.09
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS MAPPO |
$50.09
|
| Rate for Payer: BCBS Trust/PPO |
$76.60
|
| Rate for Payer: BCN Commercial |
$75.75
|
| Rate for Payer: BCN Medicare Advantage |
$50.09
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Cofinity Commercial |
$72.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.59
|
| Rate for Payer: PACE SWMI |
$50.09
|
| Rate for Payer: PHP Medicare Advantage |
$50.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.62
|
| Rate for Payer: Priority Health Medicare |
$50.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.09
|
| Rate for Payer: UHC Medicare Advantage |
$51.59
|
|
|
PR MD RECERTIFICATION HHA PT
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS G0179
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$83.63 |
| Rate for Payer: Aetna Commercial |
$53.00
|
| Rate for Payer: Aetna Medicare |
$41.13
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: BCBS MAPPO |
$39.55
|
| Rate for Payer: BCBS Trust/PPO |
$83.63
|
| Rate for Payer: BCN Commercial |
$60.11
|
| Rate for Payer: BCN Medicare Advantage |
$39.55
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$56.95
|
| Rate for Payer: Cofinity Commercial |
$53.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.53
|
| Rate for Payer: PACE SWMI |
$39.55
|
| Rate for Payer: PHP Medicare Advantage |
$39.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.24
|
| Rate for Payer: Priority Health Medicare |
$39.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.55
|
| Rate for Payer: UHC Medicare Advantage |
$40.74
|
|
|
PR MD REVIEW INTERPRET OF TEST
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS G0250
|
| Min. Negotiated Rate |
$8.63 |
| Max. Negotiated Rate |
$459.09 |
| Rate for Payer: Aetna Commercial |
$11.56
|
| Rate for Payer: Aetna Medicare |
$8.98
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$8.63
|
| Rate for Payer: BCBS Trust/PPO |
$459.09
|
| Rate for Payer: BCN Commercial |
$12.71
|
| Rate for Payer: BCN Medicare Advantage |
$8.63
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$12.43
|
| Rate for Payer: Cofinity Commercial |
$11.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.06
|
| Rate for Payer: PACE SWMI |
$8.63
|
| Rate for Payer: PHP Medicare Advantage |
$8.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.14
|
| Rate for Payer: Priority Health Medicare |
$8.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.63
|
| Rate for Payer: UHC Medicare Advantage |
$8.89
|
|
|
PR MD SERVICE REQUIRED FOR PMD
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS G0372
|
| Min. Negotiated Rate |
$8.60 |
| Max. Negotiated Rate |
$1,453.88 |
| Rate for Payer: Aetna Commercial |
$11.52
|
| Rate for Payer: Aetna Medicare |
$8.94
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: BCBS MAPPO |
$8.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.88
|
| Rate for Payer: BCN Commercial |
$12.71
|
| Rate for Payer: BCN Medicare Advantage |
$8.60
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$12.38
|
| Rate for Payer: Cofinity Commercial |
$11.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.03
|
| Rate for Payer: PACE SWMI |
$8.60
|
| Rate for Payer: PHP Medicare Advantage |
$8.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.68
|
| Rate for Payer: Priority Health Medicare |
$8.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.60
|
| Rate for Payer: UHC Medicare Advantage |
$8.86
|
|
|
PR MEASLES MUMPS RUBELLA VARICELLA VACC LIVE SUBQ
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 90710
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$275.04 |
| Rate for Payer: Aetna Commercial |
$275.04
|
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: BCBS Trust/PPO |
$260.00
|
| Rate for Payer: BCN Commercial |
$258.46
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
|
|
PR MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 90707
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: BCBS Complete |
$42.00
|
| Rate for Payer: BCBS Trust/PPO |
$88.32
|
| Rate for Payer: BCN Commercial |
$88.32
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.50
|
|
|
PR MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 51798
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$3,662.70 |
| Rate for Payer: Aetna Commercial |
$13.31
|
| Rate for Payer: Aetna Medicare |
$10.33
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$9.93
|
| Rate for Payer: BCBS Trust/PPO |
$3,662.70
|
| Rate for Payer: BCN Commercial |
$15.64
|
| Rate for Payer: BCN Medicare Advantage |
$9.93
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$14.30
|
| Rate for Payer: Cofinity Commercial |
$13.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.43
|
| Rate for Payer: PACE SWMI |
$9.93
|
| Rate for Payer: PHP Medicare Advantage |
$9.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.29
|
| Rate for Payer: Priority Health Medicare |
$9.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.93
|
| Rate for Payer: UHC Medicare Advantage |
$10.23
|
|
|
PR MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT
|
Professional
|
Both
|
$335.00
|
|
|
Service Code
|
HCPCS 53020
|
| Min. Negotiated Rate |
$61.13 |
| Max. Negotiated Rate |
$359.24 |
| Rate for Payer: Aetna Commercial |
$126.28
|
| Rate for Payer: Aetna Medicare |
$98.01
|
| Rate for Payer: BCBS Complete |
$64.19
|
| Rate for Payer: BCBS MAPPO |
$94.24
|
| Rate for Payer: BCBS Trust/PPO |
$359.24
|
| Rate for Payer: BCN Commercial |
$138.79
|
| Rate for Payer: BCN Medicare Advantage |
$94.24
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cofinity Commercial |
$135.71
|
| Rate for Payer: Cofinity Commercial |
$126.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.24
|
| Rate for Payer: Mclaren Medicaid |
$61.13
|
| Rate for Payer: Meridian Medicaid |
$64.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.95
|
| Rate for Payer: PACE SWMI |
$94.24
|
| Rate for Payer: PHP Medicare Advantage |
$94.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.46
|
| Rate for Payer: Priority Health Medicare |
$94.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$153.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.24
|
| Rate for Payer: UHC Medicare Advantage |
$97.07
|
|
|
PR MEATOTOMY CUTTING MEATUS SPX INFANT
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
HCPCS 53025
|
| Min. Negotiated Rate |
$43.67 |
| Max. Negotiated Rate |
$718.49 |
| Rate for Payer: Aetna Commercial |
$89.18
|
| Rate for Payer: Aetna Medicare |
$69.21
|
| Rate for Payer: BCBS Complete |
$45.85
|
| Rate for Payer: BCBS MAPPO |
$66.55
|
| Rate for Payer: BCBS Trust/PPO |
$718.49
|
| Rate for Payer: BCN Commercial |
$98.72
|
| Rate for Payer: BCN Medicare Advantage |
$66.55
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cofinity Commercial |
$89.18
|
| Rate for Payer: Cofinity Commercial |
$95.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.55
|
| Rate for Payer: Mclaren Medicaid |
$43.67
|
| Rate for Payer: Meridian Medicaid |
$45.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.88
|
| Rate for Payer: PACE SWMI |
$66.55
|
| Rate for Payer: PHP Medicare Advantage |
$66.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.15
|
| Rate for Payer: Priority Health Medicare |
$66.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.55
|
| Rate for Payer: UHC Medicare Advantage |
$68.55
|
|
|
PR MEDIASTINOSCOPY INCL BIOPSIES WHEN PERFORMED
|
Professional
|
Both
|
$2,199.00
|
|
|
Service Code
|
HCPCS 39400
|
| Min. Negotiated Rate |
$879.60 |
| Max. Negotiated Rate |
$1,539.30 |
| Rate for Payer: BCBS Complete |
$879.60
|
| Rate for Payer: Cash Price |
$1,759.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,539.30
|
|
|
PR MEDIASTINOSCOPY INCLUDES MEDIASTINAL MASS BIOPSY
|
Professional
|
Both
|
$951.00
|
|
|
Service Code
|
HCPCS 39401
|
| Min. Negotiated Rate |
$194.04 |
| Max. Negotiated Rate |
$665.70 |
| Rate for Payer: Aetna Commercial |
$406.37
|
| Rate for Payer: Aetna Medicare |
$315.39
|
| Rate for Payer: BCBS Complete |
$203.74
|
| Rate for Payer: BCBS MAPPO |
$303.26
|
| Rate for Payer: BCBS Trust/PPO |
$207.62
|
| Rate for Payer: BCN Commercial |
$442.74
|
| Rate for Payer: BCN Medicare Advantage |
$303.26
|
| Rate for Payer: Cash Price |
$760.80
|
| Rate for Payer: Cash Price |
$760.80
|
| Rate for Payer: Cofinity Commercial |
$406.37
|
| Rate for Payer: Cofinity Commercial |
$436.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.26
|
| Rate for Payer: Mclaren Medicaid |
$194.04
|
| Rate for Payer: Meridian Medicaid |
$203.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$318.42
|
| Rate for Payer: PACE SWMI |
$303.26
|
| Rate for Payer: PHP Medicare Advantage |
$303.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.96
|
| Rate for Payer: Priority Health Medicare |
$303.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$481.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.26
|
| Rate for Payer: UHC Medicare Advantage |
$312.36
|
|
