|
PR MEDIASTINOSCOPY WITH LYMPH NODE BIOPSY/IES
|
Professional
|
Both
|
$828.00
|
|
|
Service Code
|
HCPCS 39402
|
| Min. Negotiated Rate |
$253.26 |
| Max. Negotiated Rate |
$629.31 |
| Rate for Payer: Aetna Commercial |
$531.56
|
| Rate for Payer: Aetna Medicare |
$412.56
|
| Rate for Payer: BCBS Complete |
$265.92
|
| Rate for Payer: BCBS MAPPO |
$396.69
|
| Rate for Payer: BCBS Trust/PPO |
$487.62
|
| Rate for Payer: BCN Commercial |
$578.11
|
| Rate for Payer: BCN Medicare Advantage |
$396.69
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cofinity Commercial |
$531.56
|
| Rate for Payer: Cofinity Commercial |
$571.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.69
|
| Rate for Payer: Mclaren Medicaid |
$253.26
|
| Rate for Payer: Meridian Medicaid |
$265.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$416.52
|
| Rate for Payer: PACE SWMI |
$396.69
|
| Rate for Payer: PHP Medicare Advantage |
$396.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$579.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$629.31
|
| Rate for Payer: Priority Health Medicare |
$396.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$629.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$396.69
|
| Rate for Payer: UHC Medicare Advantage |
$408.59
|
|
|
PR MEDIAST W/EXPL DRG RMVL FB/BX CRV APPR
|
Professional
|
Both
|
$2,499.00
|
|
|
Service Code
|
HCPCS 39000
|
| Min. Negotiated Rate |
$322.70 |
| Max. Negotiated Rate |
$1,749.30 |
| Rate for Payer: Aetna Commercial |
$635.15
|
| Rate for Payer: Aetna Medicare |
$492.95
|
| Rate for Payer: BCBS Complete |
$338.84
|
| Rate for Payer: BCBS MAPPO |
$473.99
|
| Rate for Payer: BCBS Trust/PPO |
$418.94
|
| Rate for Payer: BCN Commercial |
$700.27
|
| Rate for Payer: BCN Medicare Advantage |
$473.99
|
| Rate for Payer: Cash Price |
$1,999.20
|
| Rate for Payer: Cash Price |
$1,999.20
|
| Rate for Payer: Cofinity Commercial |
$682.55
|
| Rate for Payer: Cofinity Commercial |
$635.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$473.99
|
| Rate for Payer: Mclaren Medicaid |
$322.70
|
| Rate for Payer: Meridian Medicaid |
$338.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$497.69
|
| Rate for Payer: PACE SWMI |
$473.99
|
| Rate for Payer: PHP Medicare Advantage |
$473.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,749.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$762.29
|
| Rate for Payer: Priority Health Medicare |
$473.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$762.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$473.99
|
| Rate for Payer: UHC Medicare Advantage |
$488.21
|
|
|
PR MEDIAST W/EXPL DRG RMVL FB/BX TTHRC APPR
|
Professional
|
Both
|
$5,144.00
|
|
|
Service Code
|
HCPCS 39010
|
| Min. Negotiated Rate |
$499.91 |
| Max. Negotiated Rate |
$3,600.80 |
| Rate for Payer: Aetna Commercial |
$1,039.61
|
| Rate for Payer: Aetna Medicare |
$806.86
|
| Rate for Payer: BCBS Complete |
$524.91
|
| Rate for Payer: BCBS MAPPO |
$775.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,750.26
|
| Rate for Payer: BCN Commercial |
$1,138.13
|
| Rate for Payer: BCN Medicare Advantage |
$775.83
|
| Rate for Payer: Cash Price |
$4,115.20
|
| Rate for Payer: Cash Price |
$4,115.20
|
| Rate for Payer: Cofinity Commercial |
$1,039.61
|
| Rate for Payer: Cofinity Commercial |
$1,117.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.83
|
| Rate for Payer: Mclaren Medicaid |
$499.91
|
| Rate for Payer: Meridian Medicaid |
$524.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$814.62
|
| Rate for Payer: PACE SWMI |
$775.83
|
| Rate for Payer: PHP Medicare Advantage |
$775.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,600.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,238.92
|
| Rate for Payer: Priority Health Medicare |
$775.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,238.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$775.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$775.83
|
| Rate for Payer: UHC Medicare Advantage |
$799.10
|
|
|
PR MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS 97802
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$1,112.07 |
| Rate for Payer: Aetna Commercial |
$41.93
|
| Rate for Payer: Aetna Medicare |
$32.54
|
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: BCBS MAPPO |
$31.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,112.07
|
| Rate for Payer: BCN Commercial |
$53.26
|
| Rate for Payer: BCN Medicare Advantage |
$31.29
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$45.06
|
| Rate for Payer: Cofinity Commercial |
$41.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.85
|
| Rate for Payer: PACE SWMI |
$31.29
|
| Rate for Payer: PHP Medicare Advantage |
$31.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.34
|
| Rate for Payer: Priority Health Medicare |
$31.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.29
|
| Rate for Payer: UHC Medicare Advantage |
$32.23
|
|
|
PR MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 97803
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$561.58 |
| Rate for Payer: Aetna Commercial |
$35.40
|
| Rate for Payer: Aetna Medicare |
$27.48
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: BCBS MAPPO |
$26.42
|
| Rate for Payer: BCBS Trust/PPO |
$561.58
|
| Rate for Payer: BCN Commercial |
$46.43
|
| Rate for Payer: BCN Medicare Advantage |
$26.42
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$35.40
|
| Rate for Payer: Cofinity Commercial |
$38.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.74
|
| Rate for Payer: PACE SWMI |
$26.42
|
| Rate for Payer: PHP Medicare Advantage |
$26.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.82
|
| Rate for Payer: Priority Health Medicare |
$26.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.42
|
| Rate for Payer: UHC Medicare Advantage |
$27.21
|
|
|
PR MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 97804
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$641.36 |
| Rate for Payer: Aetna Commercial |
$20.11
|
| Rate for Payer: Aetna Medicare |
$15.61
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS MAPPO |
$15.01
|
| Rate for Payer: BCBS Trust/PPO |
$641.36
|
| Rate for Payer: BCN Commercial |
$24.44
|
| Rate for Payer: BCN Medicare Advantage |
$15.01
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$20.11
|
| Rate for Payer: Cofinity Commercial |
$21.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.76
|
| Rate for Payer: PACE SWMI |
$15.01
|
| Rate for Payer: PHP Medicare Advantage |
$15.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.57
|
| Rate for Payer: Priority Health Medicare |
$15.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.01
|
| Rate for Payer: UHC Medicare Advantage |
$15.46
|
|
|
PR MEDICATION ADMIN & HEMODYNAMIC MEASURMENT
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 93463
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$735.92 |
| Rate for Payer: Aetna Commercial |
$128.08
|
| Rate for Payer: Aetna Medicare |
$99.40
|
| Rate for Payer: BCBS Complete |
$63.97
|
| Rate for Payer: BCBS MAPPO |
$95.58
|
| Rate for Payer: BCBS Trust/PPO |
$735.92
|
| Rate for Payer: BCN Commercial |
$140.25
|
| Rate for Payer: BCN Medicare Advantage |
$95.58
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$137.64
|
| Rate for Payer: Cofinity Commercial |
$128.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.58
|
| Rate for Payer: Mclaren Medicaid |
$60.92
|
| Rate for Payer: Meridian Medicaid |
$63.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.36
|
| Rate for Payer: PACE SWMI |
$95.58
|
| Rate for Payer: PHP Medicare Advantage |
$95.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.72
|
| Rate for Payer: Priority Health Medicare |
$95.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$135.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.58
|
| Rate for Payer: UHC Medicare Advantage |
$98.45
|
|
|
PR MEDICATION THERAPY EACH ADDITIONAL 15 MIN
|
Professional
|
Both
|
$13.00
|
|
|
Service Code
|
HCPCS 99607
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$370.34 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$370.34
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
|
|
PR MEDICATION THERAPY INITIAL 15 MIN ESTABLISHED PT
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 99606
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$62.87 |
| Rate for Payer: Aetna Commercial |
$33.89
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS Trust/PPO |
$62.87
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
|
|
PR MEDICATION THERAPY INITIAL 15 MIN NEW PATIENT
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 99605
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$79.81 |
| Rate for Payer: Aetna Commercial |
$67.55
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCBS Trust/PPO |
$79.81
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.10
|
|
|
PR MEDROXYPROGESTERONE ACETATE
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
HCPCS J1050
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$0.70 |
| Rate for Payer: Aetna Commercial |
$0.52
|
| Rate for Payer: BCBS Complete |
$0.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.14
|
| Rate for Payer: BCN Commercial |
$0.14
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.70
|
|
|
PR MEDROXYPROGESTERONE INJ
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS J1051
|
| 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 MEDRXYPROGESTER ACETATE INJ
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS J1055
|
| Min. Negotiated Rate |
$32.00 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: BCBS Complete |
$32.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
|
|
PR MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 90734
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$151.33 |
| Rate for Payer: Aetna Commercial |
$151.33
|
| Rate for Payer: BCBS Complete |
$56.00
|
| Rate for Payer: BCBS Trust/PPO |
$150.00
|
| Rate for Payer: BCN Commercial |
$147.22
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.00
|
|
|
PR MENACWY-TT CONJ VACC SEROGROUPS ACWY FOR IM USE
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 90619
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$168.36 |
| Rate for Payer: Aetna Commercial |
$159.10
|
| Rate for Payer: BCBS Complete |
$72.00
|
| Rate for Payer: BCBS Trust/PPO |
$168.36
|
| Rate for Payer: BCN Commercial |
$168.36
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.00
|
|
|
PR MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM
|
Professional
|
Both
|
$232.00
|
|
|
Service Code
|
HCPCS 90620
|
| Min. Negotiated Rate |
$92.80 |
| Max. Negotiated Rate |
$215.42 |
| Rate for Payer: Aetna Commercial |
$215.42
|
| Rate for Payer: BCBS Complete |
$92.80
|
| Rate for Payer: BCBS Trust/PPO |
$198.55
|
| Rate for Payer: BCN Commercial |
$198.55
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.40
|
|
|
PR MENB-FHBP RECOMBNT LIPOPROTEIN VACC 2/3 DOSE IM
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 90621
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$183.17 |
| Rate for Payer: Aetna Commercial |
$183.17
|
| Rate for Payer: BCBS Complete |
$72.00
|
| Rate for Payer: BCBS Trust/PPO |
$165.84
|
| Rate for Payer: BCN Commercial |
$165.84
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.00
|
|
|
PR MEPERIDINE HYDROCHL /100 MG
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J2175
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$10.52 |
| Rate for Payer: Aetna Commercial |
$9.79
|
| Rate for Payer: Aetna Medicare |
$7.60
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$7.31
|
| Rate for Payer: BCBS Trust/PPO |
$1.87
|
| Rate for Payer: BCN Commercial |
$1.88
|
| Rate for Payer: BCN Medicare Advantage |
$7.31
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$10.52
|
| Rate for Payer: Cofinity Commercial |
$9.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.67
|
| Rate for Payer: PACE SWMI |
$7.31
|
| Rate for Payer: PHP Medicare Advantage |
$7.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.00
|
| Rate for Payer: Priority Health Medicare |
$7.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.31
|
| Rate for Payer: UHC Medicare Advantage |
$7.53
|
|
|
PR MEPERIDINE/PROMETHAZINE INJ
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS J2180
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$7.70 |
| Rate for Payer: Aetna Commercial |
$7.58
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.70
|
|
|
PR METATARSECTOMY
|
Professional
|
Both
|
$1,050.00
|
|
|
Service Code
|
HCPCS 28140
|
| Min. Negotiated Rate |
$273.49 |
| Max. Negotiated Rate |
$1,034.26 |
| Rate for Payer: Aetna Commercial |
$562.28
|
| Rate for Payer: Aetna Medicare |
$436.39
|
| Rate for Payer: BCBS Complete |
$287.16
|
| Rate for Payer: BCBS MAPPO |
$419.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.26
|
| Rate for Payer: BCN Commercial |
$830.26
|
| Rate for Payer: BCN Medicare Advantage |
$419.61
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cash Price |
$840.00
|
| Rate for Payer: Cofinity Commercial |
$604.24
|
| Rate for Payer: Cofinity Commercial |
$562.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$419.61
|
| Rate for Payer: Mclaren Medicaid |
$273.49
|
| Rate for Payer: Meridian Medicaid |
$287.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$440.59
|
| Rate for Payer: PACE SWMI |
$419.61
|
| Rate for Payer: PHP Medicare Advantage |
$419.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$735.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$650.05
|
| Rate for Payer: Priority Health Medicare |
$419.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$650.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$419.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$419.61
|
| Rate for Payer: UHC Medicare Advantage |
$432.20
|
|
|
PR METHYLPREDNISOLONE 20 MG INJ
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J1020
|
| Min. Negotiated Rate |
$1.75 |
| Max. Negotiated Rate |
$10.32 |
| Rate for Payer: Aetna Commercial |
$9.60
|
| Rate for Payer: Aetna Medicare |
$7.45
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$7.17
|
| Rate for Payer: BCBS Trust/PPO |
$1.79
|
| Rate for Payer: BCN Commercial |
$1.75
|
| Rate for Payer: BCN Medicare Advantage |
$7.17
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$10.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.53
|
| Rate for Payer: PACE SWMI |
$7.17
|
| Rate for Payer: PHP Medicare Advantage |
$7.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.00
|
| Rate for Payer: Priority Health Medicare |
$7.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.17
|
| Rate for Payer: UHC Medicare Advantage |
$7.38
|
|
|
PR METHYLPREDNISOLONE 40 MG INJ
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS J1030
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$10.96 |
| Rate for Payer: Aetna Commercial |
$10.20
|
| Rate for Payer: Aetna Medicare |
$7.92
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS MAPPO |
$7.61
|
| Rate for Payer: BCBS Trust/PPO |
$3.27
|
| Rate for Payer: BCN Commercial |
$6.37
|
| Rate for Payer: BCN Medicare Advantage |
$7.61
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$10.20
|
| Rate for Payer: Cofinity Commercial |
$10.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.99
|
| Rate for Payer: PACE SWMI |
$7.61
|
| Rate for Payer: PHP Medicare Advantage |
$7.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.50
|
| Rate for Payer: Priority Health Medicare |
$7.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.61
|
| Rate for Payer: UHC Medicare Advantage |
$7.84
|
|
|
PR METHYLPREDNISOLONE 80 MG INJ
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS J1040
|
| Min. Negotiated Rate |
$5.37 |
| Max. Negotiated Rate |
$17.50 |
| Rate for Payer: Aetna Commercial |
$15.96
|
| Rate for Payer: Aetna Medicare |
$12.39
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: BCBS MAPPO |
$11.91
|
| Rate for Payer: BCBS Trust/PPO |
$5.37
|
| Rate for Payer: BCN Commercial |
$10.71
|
| Rate for Payer: BCN Medicare Advantage |
$11.91
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$17.15
|
| Rate for Payer: Cofinity Commercial |
$15.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.51
|
| Rate for Payer: PACE SWMI |
$11.91
|
| Rate for Payer: PHP Medicare Advantage |
$11.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health Medicare |
$11.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.91
|
| Rate for Payer: UHC Medicare Advantage |
$12.27
|
|
|
PR METHYLPREDNISOLONE INJECTION
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS J2930
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$17.50 |
| Rate for Payer: Aetna Commercial |
$7.67
|
| Rate for Payer: Aetna Medicare |
$5.95
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: BCBS MAPPO |
$5.72
|
| Rate for Payer: BCBS Trust/PPO |
$3.00
|
| Rate for Payer: BCN Commercial |
$2.84
|
| Rate for Payer: BCN Medicare Advantage |
$5.72
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$7.67
|
| Rate for Payer: Cofinity Commercial |
$8.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.01
|
| Rate for Payer: PACE SWMI |
$5.72
|
| Rate for Payer: PHP Medicare Advantage |
$5.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health Medicare |
$5.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.72
|
| Rate for Payer: UHC Medicare Advantage |
$5.90
|
|
|
PR METHYLPREDNISOLONE INJECTION
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS J2920
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$7.00 |
| Rate for Payer: Aetna Commercial |
$5.68
|
| Rate for Payer: Aetna Medicare |
$4.41
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$4.24
|
| Rate for Payer: BCBS Trust/PPO |
$3.17
|
| Rate for Payer: BCN Commercial |
$3.53
|
| Rate for Payer: BCN Medicare Advantage |
$4.24
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$6.10
|
| Rate for Payer: Cofinity Commercial |
$5.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.45
|
| Rate for Payer: PACE SWMI |
$4.24
|
| Rate for Payer: PHP Medicare Advantage |
$4.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.00
|
| Rate for Payer: Priority Health Medicare |
$4.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.24
|
| Rate for Payer: UHC Medicare Advantage |
$4.36
|
|
