|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
HCPCS 95867
|
| Min. Negotiated Rate |
$76.40 |
| Max. Negotiated Rate |
$620.75 |
| Rate for Payer: Aetna Commercial |
$135.94
|
| Rate for Payer: Aetna Medicare |
$105.51
|
| Rate for Payer: BCBS Complete |
$76.40
|
| Rate for Payer: BCBS MAPPO |
$101.45
|
| Rate for Payer: BCBS Trust/PPO |
$620.75
|
| Rate for Payer: BCN Commercial |
$156.38
|
| Rate for Payer: BCN Medicare Advantage |
$101.45
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cofinity Commercial |
$135.94
|
| Rate for Payer: Cofinity Commercial |
$146.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$106.52
|
| Rate for Payer: PACE SWMI |
$101.45
|
| Rate for Payer: PHP Medicare Advantage |
$101.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.73
|
| Rate for Payer: Priority Health Medicare |
$101.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$143.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.45
|
| Rate for Payer: UHC Medicare Advantage |
$104.49
|
|
|
PR NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM
|
Professional
|
Both
|
$232.00
|
|
|
Service Code
|
HCPCS 95866
|
| Min. Negotiated Rate |
$92.80 |
| Max. Negotiated Rate |
$665.13 |
| Rate for Payer: Aetna Commercial |
$161.79
|
| Rate for Payer: Aetna Medicare |
$125.57
|
| Rate for Payer: BCBS Complete |
$92.80
|
| Rate for Payer: BCBS MAPPO |
$120.74
|
| Rate for Payer: BCBS Trust/PPO |
$665.13
|
| Rate for Payer: BCN Commercial |
$184.72
|
| Rate for Payer: BCN Medicare Advantage |
$120.74
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cofinity Commercial |
$173.87
|
| Rate for Payer: Cofinity Commercial |
$161.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.78
|
| Rate for Payer: PACE SWMI |
$120.74
|
| Rate for Payer: PHP Medicare Advantage |
$120.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.77
|
| Rate for Payer: Priority Health Medicare |
$120.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$169.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.74
|
| Rate for Payer: UHC Medicare Advantage |
$124.36
|
|
|
PR NEEDLE ELECTROMYOGRAPHY LARYNX
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 95865
|
| Min. Negotiated Rate |
$142.81 |
| Max. Negotiated Rate |
$990.03 |
| Rate for Payer: Aetna Commercial |
$191.37
|
| Rate for Payer: Aetna Medicare |
$148.52
|
| Rate for Payer: BCBS Complete |
$146.00
|
| Rate for Payer: BCBS MAPPO |
$142.81
|
| Rate for Payer: BCBS Trust/PPO |
$990.03
|
| Rate for Payer: BCN Commercial |
$217.95
|
| Rate for Payer: BCN Medicare Advantage |
$142.81
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$205.65
|
| Rate for Payer: Cofinity Commercial |
$191.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$149.95
|
| Rate for Payer: PACE SWMI |
$142.81
|
| Rate for Payer: PHP Medicare Advantage |
$142.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$255.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.32
|
| Rate for Payer: Priority Health Medicare |
$142.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$200.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.81
|
| Rate for Payer: UHC Medicare Advantage |
$147.09
|
|
|
PR NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 95885
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$1,360.37 |
| Rate for Payer: Aetna Commercial |
$78.01
|
| Rate for Payer: Aetna Commercial |
$78.01
|
| Rate for Payer: Aetna Medicare |
$60.55
|
| Rate for Payer: Aetna Medicare |
$60.55
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCBS Complete |
$60.40
|
| Rate for Payer: BCBS MAPPO |
$58.22
|
| Rate for Payer: BCBS MAPPO |
$58.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,360.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,360.37
|
| Rate for Payer: BCN Commercial |
$90.41
|
| Rate for Payer: BCN Commercial |
$90.41
|
| Rate for Payer: BCN Medicare Advantage |
$58.22
|
| Rate for Payer: BCN Medicare Advantage |
$58.22
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$83.84
|
| Rate for Payer: Cofinity Commercial |
$83.84
|
| Rate for Payer: Cofinity Commercial |
$78.01
|
| Rate for Payer: Cofinity Commercial |
$78.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$61.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$61.13
|
| Rate for Payer: PACE SWMI |
$58.22
|
| Rate for Payer: PACE SWMI |
$58.22
|
| Rate for Payer: PHP Medicare Advantage |
$58.22
|
| Rate for Payer: PHP Medicare Advantage |
$58.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.09
|
| Rate for Payer: Priority Health Medicare |
$58.22
|
| Rate for Payer: Priority Health Medicare |
$58.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.22
|
| Rate for Payer: UHC Medicare Advantage |
$59.97
|
| Rate for Payer: UHC Medicare Advantage |
$59.97
|
|
|
PR NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 95886
|
| Min. Negotiated Rate |
$92.65 |
| Max. Negotiated Rate |
$1,755.54 |
| Rate for Payer: Aetna Commercial |
$124.15
|
| Rate for Payer: Aetna Commercial |
$124.15
|
| Rate for Payer: Aetna Medicare |
$96.36
|
| Rate for Payer: Aetna Medicare |
$96.36
|
| Rate for Payer: BCBS Complete |
$94.80
|
| Rate for Payer: BCBS Complete |
$66.80
|
| Rate for Payer: BCBS MAPPO |
$92.65
|
| Rate for Payer: BCBS MAPPO |
$92.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,755.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,755.54
|
| Rate for Payer: BCN Commercial |
$142.21
|
| Rate for Payer: BCN Commercial |
$142.21
|
| Rate for Payer: BCN Medicare Advantage |
$92.65
|
| Rate for Payer: BCN Medicare Advantage |
$92.65
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$124.15
|
| Rate for Payer: Cofinity Commercial |
$133.42
|
| Rate for Payer: Cofinity Commercial |
$124.15
|
| Rate for Payer: Cofinity Commercial |
$133.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$97.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$97.28
|
| Rate for Payer: PACE SWMI |
$92.65
|
| Rate for Payer: PACE SWMI |
$92.65
|
| Rate for Payer: PHP Medicare Advantage |
$92.65
|
| Rate for Payer: PHP Medicare Advantage |
$92.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.11
|
| Rate for Payer: Priority Health Medicare |
$92.65
|
| Rate for Payer: Priority Health Medicare |
$92.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.65
|
| Rate for Payer: UHC Medicare Advantage |
$95.43
|
| Rate for Payer: UHC Medicare Advantage |
$95.43
|
|
|
PR NEEDLE EMG GUID W/CHEMODENERVATION
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 95874
|
| Min. Negotiated Rate |
$49.60 |
| Max. Negotiated Rate |
$1,247.84 |
| Rate for Payer: Aetna Commercial |
$97.12
|
| Rate for Payer: Aetna Medicare |
$75.38
|
| Rate for Payer: BCBS Complete |
$49.60
|
| Rate for Payer: BCBS MAPPO |
$72.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,247.84
|
| Rate for Payer: BCN Commercial |
$112.89
|
| Rate for Payer: BCN Medicare Advantage |
$72.48
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$97.12
|
| Rate for Payer: Cofinity Commercial |
$104.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$76.10
|
| Rate for Payer: PACE SWMI |
$72.48
|
| Rate for Payer: PHP Medicare Advantage |
$72.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.75
|
| Rate for Payer: Priority Health Medicare |
$72.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.48
|
| Rate for Payer: UHC Medicare Advantage |
$74.65
|
|
|
PR NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 95870
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$288.98 |
| Rate for Payer: Aetna Commercial |
$104.72
|
| Rate for Payer: Aetna Medicare |
$81.28
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: BCBS MAPPO |
$78.15
|
| Rate for Payer: BCBS Trust/PPO |
$288.98
|
| Rate for Payer: BCN Commercial |
$121.68
|
| Rate for Payer: BCN Medicare Advantage |
$78.15
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$112.54
|
| Rate for Payer: Cofinity Commercial |
$104.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$82.06
|
| Rate for Payer: PACE SWMI |
$78.15
|
| Rate for Payer: PHP Medicare Advantage |
$78.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.84
|
| Rate for Payer: Priority Health Medicare |
$78.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.15
|
| Rate for Payer: UHC Medicare Advantage |
$80.49
|
|
|
PR NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION
|
Professional
|
Both
|
$267.00
|
|
|
Service Code
|
HCPCS 95887
|
| Min. Negotiated Rate |
$79.54 |
| Max. Negotiated Rate |
$1,456.52 |
| Rate for Payer: Aetna Commercial |
$106.58
|
| Rate for Payer: Aetna Commercial |
$106.58
|
| Rate for Payer: Aetna Medicare |
$82.72
|
| Rate for Payer: Aetna Medicare |
$82.72
|
| Rate for Payer: BCBS Complete |
$52.40
|
| Rate for Payer: BCBS Complete |
$106.80
|
| Rate for Payer: BCBS MAPPO |
$79.54
|
| Rate for Payer: BCBS MAPPO |
$79.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,456.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,456.52
|
| Rate for Payer: BCN Commercial |
$122.17
|
| Rate for Payer: BCN Commercial |
$122.17
|
| Rate for Payer: BCN Medicare Advantage |
$79.54
|
| Rate for Payer: BCN Medicare Advantage |
$79.54
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$106.58
|
| Rate for Payer: Cofinity Commercial |
$114.54
|
| Rate for Payer: Cofinity Commercial |
$106.58
|
| Rate for Payer: Cofinity Commercial |
$114.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$83.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$83.52
|
| Rate for Payer: PACE SWMI |
$79.54
|
| Rate for Payer: PACE SWMI |
$79.54
|
| Rate for Payer: PHP Medicare Advantage |
$79.54
|
| Rate for Payer: PHP Medicare Advantage |
$79.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.29
|
| Rate for Payer: Priority Health Medicare |
$79.54
|
| Rate for Payer: Priority Health Medicare |
$79.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.54
|
| Rate for Payer: UHC Medicare Advantage |
$81.93
|
| Rate for Payer: UHC Medicare Advantage |
$81.93
|
|
|
PR NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 95869
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$296.90 |
| Rate for Payer: Aetna Commercial |
$120.44
|
| Rate for Payer: Aetna Medicare |
$93.48
|
| Rate for Payer: BCBS Complete |
$57.20
|
| Rate for Payer: BCBS MAPPO |
$89.88
|
| Rate for Payer: BCBS Trust/PPO |
$296.90
|
| Rate for Payer: BCN Commercial |
$140.25
|
| Rate for Payer: BCN Medicare Advantage |
$89.88
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cofinity Commercial |
$120.44
|
| Rate for Payer: Cofinity Commercial |
$129.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$94.37
|
| Rate for Payer: PACE SWMI |
$89.88
|
| Rate for Payer: PHP Medicare Advantage |
$89.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.91
|
| Rate for Payer: Priority Health Medicare |
$89.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.88
|
| Rate for Payer: UHC Medicare Advantage |
$92.58
|
|
|
PR NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER
|
Professional
|
Both
|
$318.00
|
|
|
Service Code
|
HCPCS 95872
|
| Min. Negotiated Rate |
$127.20 |
| Max. Negotiated Rate |
$411.55 |
| Rate for Payer: Aetna Commercial |
$256.23
|
| Rate for Payer: Aetna Medicare |
$198.87
|
| Rate for Payer: BCBS Complete |
$127.20
|
| Rate for Payer: BCBS MAPPO |
$191.22
|
| Rate for Payer: BCBS Trust/PPO |
$411.55
|
| Rate for Payer: BCN Commercial |
$287.34
|
| Rate for Payer: BCN Medicare Advantage |
$191.22
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cofinity Commercial |
$275.36
|
| Rate for Payer: Cofinity Commercial |
$256.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$200.78
|
| Rate for Payer: PACE SWMI |
$191.22
|
| Rate for Payer: PHP Medicare Advantage |
$191.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$222.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$264.10
|
| Rate for Payer: Priority Health Medicare |
$191.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$264.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$191.22
|
| Rate for Payer: UHC Medicare Advantage |
$196.96
|
|
|
PR NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 20560
|
| Min. Negotiated Rate |
$14.60 |
| Max. Negotiated Rate |
$37.63 |
| Rate for Payer: Aetna Commercial |
$19.56
|
| Rate for Payer: Aetna Medicare |
$15.18
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS MAPPO |
$14.60
|
| Rate for Payer: BCBS Trust/PPO |
$37.50
|
| Rate for Payer: BCN Commercial |
$37.63
|
| Rate for Payer: BCN Medicare Advantage |
$14.60
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$19.56
|
| Rate for Payer: Cofinity Commercial |
$21.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.33
|
| Rate for Payer: PACE SWMI |
$14.60
|
| Rate for Payer: PHP Medicare Advantage |
$14.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.47
|
| Rate for Payer: Priority Health Medicare |
$14.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.60
|
| Rate for Payer: UHC Medicare Advantage |
$15.04
|
|
|
PR NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 20561
|
| Min. Negotiated Rate |
$21.93 |
| Max. Negotiated Rate |
$54.73 |
| Rate for Payer: Aetna Commercial |
$29.39
|
| Rate for Payer: Aetna Medicare |
$22.81
|
| Rate for Payer: BCBS Complete |
$29.60
|
| Rate for Payer: BCBS MAPPO |
$21.93
|
| Rate for Payer: BCBS Trust/PPO |
$37.50
|
| Rate for Payer: BCN Commercial |
$54.73
|
| Rate for Payer: BCN Medicare Advantage |
$21.93
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Cofinity Commercial |
$29.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.03
|
| Rate for Payer: PACE SWMI |
$21.93
|
| Rate for Payer: PHP Medicare Advantage |
$21.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.71
|
| Rate for Payer: Priority Health Medicare |
$21.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.93
|
| Rate for Payer: UHC Medicare Advantage |
$22.59
|
|
|
PR NEEDLE OCULOGRAPHY 1/ XOC MUSC 1/BOTH EYE W/I&R
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 92265
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$1,168.07 |
| Rate for Payer: Aetna Commercial |
$110.15
|
| Rate for Payer: Aetna Medicare |
$85.49
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS MAPPO |
$82.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,168.07
|
| Rate for Payer: BCN Commercial |
$126.08
|
| Rate for Payer: BCN Medicare Advantage |
$82.20
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cofinity Commercial |
$118.37
|
| Rate for Payer: Cofinity Commercial |
$110.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$86.31
|
| Rate for Payer: PACE SWMI |
$82.20
|
| Rate for Payer: PHP Medicare Advantage |
$82.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.58
|
| Rate for Payer: Priority Health Medicare |
$82.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.20
|
| Rate for Payer: UHC Medicare Advantage |
$84.67
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 97605
|
| Min. Negotiated Rate |
$15.34 |
| Max. Negotiated Rate |
$796.68 |
| Rate for Payer: Aetna Commercial |
$32.50
|
| Rate for Payer: Aetna Medicare |
$25.22
|
| Rate for Payer: BCBS Complete |
$16.11
|
| Rate for Payer: BCBS MAPPO |
$24.25
|
| Rate for Payer: BCBS Trust/PPO |
$796.68
|
| Rate for Payer: BCN Commercial |
$62.06
|
| Rate for Payer: BCN Medicare Advantage |
$24.25
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cofinity Commercial |
$34.92
|
| Rate for Payer: Cofinity Commercial |
$32.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.25
|
| Rate for Payer: Mclaren Medicaid |
$15.34
|
| Rate for Payer: Meridian Medicaid |
$16.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.46
|
| Rate for Payer: PACE SWMI |
$24.25
|
| Rate for Payer: PHP Medicare Advantage |
$24.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.51
|
| Rate for Payer: Priority Health Medicare |
$24.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.25
|
| Rate for Payer: UHC Medicare Advantage |
$24.98
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 97606
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$1,160.68 |
| Rate for Payer: Aetna Commercial |
$35.18
|
| Rate for Payer: Aetna Medicare |
$27.30
|
| Rate for Payer: BCBS Complete |
$17.67
|
| Rate for Payer: BCBS MAPPO |
$26.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,160.68
|
| Rate for Payer: BCN Commercial |
$74.28
|
| Rate for Payer: BCN Medicare Advantage |
$26.25
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cofinity Commercial |
$37.80
|
| Rate for Payer: Cofinity Commercial |
$35.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.25
|
| Rate for Payer: Mclaren Medicaid |
$16.83
|
| Rate for Payer: Meridian Medicaid |
$17.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.56
|
| Rate for Payer: PACE SWMI |
$26.25
|
| Rate for Payer: PHP Medicare Advantage |
$26.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.30
|
| Rate for Payer: Priority Health Medicare |
$26.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.25
|
| Rate for Payer: UHC Medicare Advantage |
$27.04
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 97607
|
| Min. Negotiated Rate |
$13.42 |
| Max. Negotiated Rate |
$768.68 |
| Rate for Payer: Aetna Commercial |
$29.06
|
| Rate for Payer: Aetna Medicare |
$22.56
|
| Rate for Payer: BCBS Complete |
$14.09
|
| Rate for Payer: BCBS MAPPO |
$21.69
|
| Rate for Payer: BCBS Trust/PPO |
$768.68
|
| Rate for Payer: BCN Commercial |
$535.59
|
| Rate for Payer: BCN Medicare Advantage |
$21.69
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$31.23
|
| Rate for Payer: Cofinity Commercial |
$29.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.69
|
| Rate for Payer: Mclaren Medicaid |
$13.42
|
| Rate for Payer: Meridian Medicaid |
$14.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.77
|
| Rate for Payer: PACE SWMI |
$21.69
|
| Rate for Payer: PHP Medicare Advantage |
$21.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.82
|
| Rate for Payer: Priority Health Medicare |
$21.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.69
|
| Rate for Payer: UHC Medicare Advantage |
$22.34
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 97608
|
| Min. Negotiated Rate |
$15.76 |
| Max. Negotiated Rate |
$1,073.51 |
| Rate for Payer: Aetna Commercial |
$33.63
|
| Rate for Payer: Aetna Medicare |
$26.10
|
| Rate for Payer: BCBS Complete |
$16.55
|
| Rate for Payer: BCBS MAPPO |
$25.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,073.51
|
| Rate for Payer: BCN Commercial |
$537.55
|
| Rate for Payer: BCN Medicare Advantage |
$25.10
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$33.63
|
| Rate for Payer: Cofinity Commercial |
$36.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.10
|
| Rate for Payer: Mclaren Medicaid |
$15.76
|
| Rate for Payer: Meridian Medicaid |
$16.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.36
|
| Rate for Payer: PACE SWMI |
$25.10
|
| Rate for Payer: PHP Medicare Advantage |
$25.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.48
|
| Rate for Payer: Priority Health Medicare |
$25.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.10
|
| Rate for Payer: UHC Medicare Advantage |
$25.85
|
|
|
PR NEPHRECTOMY PARTIAL
|
Professional
|
Both
|
$2,480.00
|
|
|
Service Code
|
HCPCS 50240
|
| Min. Negotiated Rate |
$841.99 |
| Max. Negotiated Rate |
$3,703.38 |
| Rate for Payer: Aetna Commercial |
$1,734.32
|
| Rate for Payer: Aetna Medicare |
$1,346.04
|
| Rate for Payer: BCBS Complete |
$884.09
|
| Rate for Payer: BCBS MAPPO |
$1,294.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,703.38
|
| Rate for Payer: BCN Commercial |
$1,906.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,294.27
|
| Rate for Payer: Cash Price |
$1,984.00
|
| Rate for Payer: Cash Price |
$1,984.00
|
| Rate for Payer: Cofinity Commercial |
$1,863.75
|
| Rate for Payer: Cofinity Commercial |
$1,734.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,294.27
|
| Rate for Payer: Mclaren Medicaid |
$841.99
|
| Rate for Payer: Meridian Medicaid |
$884.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,358.98
|
| Rate for Payer: PACE SWMI |
$1,294.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,294.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$841.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,736.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,108.48
|
| Rate for Payer: Priority Health Medicare |
$1,294.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,108.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,294.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,294.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,333.10
|
|
|
PR NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN
|
Professional
|
Both
|
$2,753.00
|
|
|
Service Code
|
HCPCS 50236
|
| Min. Negotiated Rate |
$925.91 |
| Max. Negotiated Rate |
$5,250.25 |
| Rate for Payer: Aetna Commercial |
$1,913.60
|
| Rate for Payer: Aetna Medicare |
$1,485.18
|
| Rate for Payer: BCBS Complete |
$972.21
|
| Rate for Payer: BCBS MAPPO |
$1,428.06
|
| Rate for Payer: BCBS Trust/PPO |
$5,250.25
|
| Rate for Payer: BCN Commercial |
$2,103.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.06
|
| Rate for Payer: Cash Price |
$2,202.40
|
| Rate for Payer: Cash Price |
$2,202.40
|
| Rate for Payer: Cofinity Commercial |
$1,913.60
|
| Rate for Payer: Cofinity Commercial |
$2,056.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.06
|
| Rate for Payer: Mclaren Medicaid |
$925.91
|
| Rate for Payer: Meridian Medicaid |
$972.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,499.46
|
| Rate for Payer: PACE SWMI |
$1,428.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$925.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,927.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,325.71
|
| Rate for Payer: Priority Health Medicare |
$1,428.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,325.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,428.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,428.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,470.90
|
|
|
PR NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ
|
Professional
|
Both
|
$3,632.00
|
|
|
Service Code
|
HCPCS 50220
|
| Min. Negotiated Rate |
$669.03 |
| Max. Negotiated Rate |
$4,223.76 |
| Rate for Payer: Aetna Commercial |
$1,384.69
|
| Rate for Payer: Aetna Medicare |
$1,074.68
|
| Rate for Payer: BCBS Complete |
$702.48
|
| Rate for Payer: BCBS MAPPO |
$1,033.35
|
| Rate for Payer: BCBS Trust/PPO |
$4,223.76
|
| Rate for Payer: BCN Commercial |
$1,521.26
|
| Rate for Payer: BCN Medicare Advantage |
$1,033.35
|
| Rate for Payer: Cash Price |
$2,905.60
|
| Rate for Payer: Cash Price |
$2,905.60
|
| Rate for Payer: Cofinity Commercial |
$1,488.02
|
| Rate for Payer: Cofinity Commercial |
$1,384.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,033.35
|
| Rate for Payer: Mclaren Medicaid |
$669.03
|
| Rate for Payer: Meridian Medicaid |
$702.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,085.02
|
| Rate for Payer: PACE SWMI |
$1,033.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,033.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$669.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,542.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,682.14
|
| Rate for Payer: Priority Health Medicare |
$1,033.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,682.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,033.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,033.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,064.35
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD
|
Professional
|
Both
|
$4,298.00
|
|
|
Service Code
|
HCPCS 50230
|
| Min. Negotiated Rate |
$809.83 |
| Max. Negotiated Rate |
$3,770.48 |
| Rate for Payer: Aetna Commercial |
$1,677.01
|
| Rate for Payer: Aetna Medicare |
$1,301.56
|
| Rate for Payer: BCBS Complete |
$850.32
|
| Rate for Payer: BCBS MAPPO |
$1,251.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,770.48
|
| Rate for Payer: BCN Commercial |
$1,839.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,251.50
|
| Rate for Payer: Cash Price |
$3,438.40
|
| Rate for Payer: Cash Price |
$3,438.40
|
| Rate for Payer: Cofinity Commercial |
$1,677.01
|
| Rate for Payer: Cofinity Commercial |
$1,802.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,251.50
|
| Rate for Payer: Mclaren Medicaid |
$809.83
|
| Rate for Payer: Meridian Medicaid |
$850.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,314.08
|
| Rate for Payer: PACE SWMI |
$1,251.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,251.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$809.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,008.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,034.44
|
| Rate for Payer: Priority Health Medicare |
$1,251.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,034.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,251.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,251.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,289.04
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL
|
Professional
|
Both
|
$3,386.00
|
|
|
Service Code
|
HCPCS 50225
|
| Min. Negotiated Rate |
$768.50 |
| Max. Negotiated Rate |
$3,687.01 |
| Rate for Payer: Aetna Commercial |
$1,580.42
|
| Rate for Payer: Aetna Medicare |
$1,226.60
|
| Rate for Payer: BCBS Complete |
$806.92
|
| Rate for Payer: BCBS MAPPO |
$1,179.42
|
| Rate for Payer: BCBS Trust/PPO |
$3,687.01
|
| Rate for Payer: BCN Commercial |
$1,734.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,179.42
|
| Rate for Payer: Cash Price |
$2,708.80
|
| Rate for Payer: Cash Price |
$2,708.80
|
| Rate for Payer: Cofinity Commercial |
$1,580.42
|
| Rate for Payer: Cofinity Commercial |
$1,698.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,179.42
|
| Rate for Payer: Mclaren Medicaid |
$768.50
|
| Rate for Payer: Meridian Medicaid |
$806.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,238.39
|
| Rate for Payer: PACE SWMI |
$1,179.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,179.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$768.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,370.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,918.28
|
| Rate for Payer: Priority Health Medicare |
$1,179.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,918.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,179.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,179.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,214.80
|
|
|
PR NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC
|
Professional
|
Both
|
$2,439.00
|
|
|
Service Code
|
HCPCS 50234
|
| Min. Negotiated Rate |
$823.25 |
| Max. Negotiated Rate |
$4,336.29 |
| Rate for Payer: Aetna Commercial |
$1,706.78
|
| Rate for Payer: Aetna Medicare |
$1,324.67
|
| Rate for Payer: BCBS Complete |
$864.41
|
| Rate for Payer: BCBS MAPPO |
$1,273.72
|
| Rate for Payer: BCBS Trust/PPO |
$4,336.29
|
| Rate for Payer: BCN Commercial |
$1,874.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,273.72
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cofinity Commercial |
$1,834.16
|
| Rate for Payer: Cofinity Commercial |
$1,706.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,273.72
|
| Rate for Payer: Mclaren Medicaid |
$823.25
|
| Rate for Payer: Meridian Medicaid |
$864.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,337.41
|
| Rate for Payer: PACE SWMI |
$1,273.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,273.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$823.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,707.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,072.27
|
| Rate for Payer: Priority Health Medicare |
$1,273.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,072.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,273.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,273.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,311.93
|
|
|
PR NEPHROLITHOTOMY REMOVAL CALCULUS
|
Professional
|
Both
|
$2,024.00
|
|
|
Service Code
|
HCPCS 50060
|
| Min. Negotiated Rate |
$721.64 |
| Max. Negotiated Rate |
$2,591.84 |
| Rate for Payer: Aetna Commercial |
$1,488.65
|
| Rate for Payer: Aetna Medicare |
$1,155.37
|
| Rate for Payer: BCBS Complete |
$757.72
|
| Rate for Payer: BCBS MAPPO |
$1,110.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,591.84
|
| Rate for Payer: BCN Commercial |
$1,636.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,110.93
|
| Rate for Payer: Cash Price |
$1,619.20
|
| Rate for Payer: Cash Price |
$1,619.20
|
| Rate for Payer: Cofinity Commercial |
$1,599.74
|
| Rate for Payer: Cofinity Commercial |
$1,488.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,110.93
|
| Rate for Payer: Mclaren Medicaid |
$721.64
|
| Rate for Payer: Meridian Medicaid |
$757.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,166.48
|
| Rate for Payer: PACE SWMI |
$1,110.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,110.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,416.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,809.65
|
| Rate for Payer: Priority Health Medicare |
$1,110.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,809.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,110.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,110.93
|
| Rate for Payer: UHC Medicare Advantage |
$1,144.26
|
|
|
PR NEPHROLITHOTOMY RMVL LARGE STAGHORN CALCULUS
|
Professional
|
Both
|
$3,347.00
|
|
|
Service Code
|
HCPCS 50075
|
| Min. Negotiated Rate |
$921.23 |
| Max. Negotiated Rate |
$2,775.16 |
| Rate for Payer: Aetna Commercial |
$1,903.31
|
| Rate for Payer: Aetna Medicare |
$1,477.20
|
| Rate for Payer: BCBS Complete |
$967.29
|
| Rate for Payer: BCBS MAPPO |
$1,420.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,775.16
|
| Rate for Payer: BCN Commercial |
$2,090.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,420.38
|
| Rate for Payer: Cash Price |
$2,677.60
|
| Rate for Payer: Cash Price |
$2,677.60
|
| Rate for Payer: Cofinity Commercial |
$2,045.35
|
| Rate for Payer: Cofinity Commercial |
$1,903.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,420.38
|
| Rate for Payer: Mclaren Medicaid |
$921.23
|
| Rate for Payer: Meridian Medicaid |
$967.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,491.40
|
| Rate for Payer: PACE SWMI |
$1,420.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,420.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$921.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,342.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,311.64
|
| Rate for Payer: Priority Health Medicare |
$1,420.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,311.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,420.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,420.38
|
| Rate for Payer: UHC Medicare Advantage |
$1,462.99
|
|
