|
PR NEPHRORRHAPHY SUTURE KIDNEY WOUND/INJURY
|
Professional
|
Both
|
$2,260.00
|
|
|
Service Code
|
HCPCS 50500
|
| Min. Negotiated Rate |
$824.10 |
| Max. Negotiated Rate |
$2,011.75 |
| Rate for Payer: Aetna Commercial |
$1,660.26
|
| Rate for Payer: Aetna Medicare |
$1,288.56
|
| Rate for Payer: BCBS Complete |
$865.30
|
| Rate for Payer: BCBS MAPPO |
$1,239.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,989.58
|
| Rate for Payer: BCN Commercial |
$1,819.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,239.00
|
| Rate for Payer: Cash Price |
$1,808.00
|
| Rate for Payer: Cash Price |
$1,808.00
|
| Rate for Payer: Cofinity Commercial |
$1,784.16
|
| Rate for Payer: Cofinity Commercial |
$1,660.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,239.00
|
| Rate for Payer: Mclaren Medicaid |
$824.10
|
| Rate for Payer: Meridian Medicaid |
$865.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,300.95
|
| Rate for Payer: PACE SWMI |
$1,239.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,239.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$824.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,582.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,011.75
|
| Rate for Payer: Priority Health Medicare |
$1,239.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,011.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,239.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,239.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,276.17
|
|
|
PR NEPHROSTOMY NEPHROTOMY W/DRAINAGE
|
Professional
|
Both
|
$1,730.00
|
|
|
Service Code
|
HCPCS 50040
|
| Min. Negotiated Rate |
$587.67 |
| Max. Negotiated Rate |
$3,134.93 |
| Rate for Payer: Aetna Commercial |
$1,209.99
|
| Rate for Payer: Aetna Medicare |
$939.10
|
| Rate for Payer: BCBS Complete |
$617.05
|
| Rate for Payer: BCBS MAPPO |
$902.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,134.93
|
| Rate for Payer: BCN Commercial |
$1,332.14
|
| Rate for Payer: BCN Medicare Advantage |
$902.98
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cash Price |
$1,384.00
|
| Rate for Payer: Cofinity Commercial |
$1,209.99
|
| Rate for Payer: Cofinity Commercial |
$1,300.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$902.98
|
| Rate for Payer: Mclaren Medicaid |
$587.67
|
| Rate for Payer: Meridian Medicaid |
$617.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$948.13
|
| Rate for Payer: PACE SWMI |
$902.98
|
| Rate for Payer: PHP Medicare Advantage |
$902.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$587.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,211.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,473.02
|
| Rate for Payer: Priority Health Medicare |
$902.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,473.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$902.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$902.98
|
| Rate for Payer: UHC Medicare Advantage |
$930.07
|
|
|
PR NERVE CONDUCTION STUDIES 11-12 STUDIES
|
Professional
|
Both
|
$522.00
|
|
|
Service Code
|
HCPCS 95912
|
| Min. Negotiated Rate |
$208.80 |
| Max. Negotiated Rate |
$8,557.53 |
| Rate for Payer: Aetna Commercial |
$318.05
|
| Rate for Payer: Aetna Commercial |
$318.05
|
| Rate for Payer: Aetna Medicare |
$246.84
|
| Rate for Payer: Aetna Medicare |
$246.84
|
| Rate for Payer: BCBS Complete |
$125.20
|
| Rate for Payer: BCBS Complete |
$208.80
|
| Rate for Payer: BCBS MAPPO |
$237.35
|
| Rate for Payer: BCBS MAPPO |
$237.35
|
| Rate for Payer: BCBS Trust/PPO |
$8,557.53
|
| Rate for Payer: BCBS Trust/PPO |
$8,557.53
|
| Rate for Payer: BCN Commercial |
$360.16
|
| Rate for Payer: BCN Commercial |
$360.16
|
| Rate for Payer: BCN Medicare Advantage |
$237.35
|
| Rate for Payer: BCN Medicare Advantage |
$237.35
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cofinity Commercial |
$341.78
|
| Rate for Payer: Cofinity Commercial |
$318.05
|
| Rate for Payer: Cofinity Commercial |
$341.78
|
| Rate for Payer: Cofinity Commercial |
$318.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$249.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$249.22
|
| Rate for Payer: PACE SWMI |
$237.35
|
| Rate for Payer: PACE SWMI |
$237.35
|
| Rate for Payer: PHP Medicare Advantage |
$237.35
|
| Rate for Payer: PHP Medicare Advantage |
$237.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.02
|
| Rate for Payer: Priority Health Medicare |
$237.35
|
| Rate for Payer: Priority Health Medicare |
$237.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$331.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$331.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.35
|
| Rate for Payer: UHC Medicare Advantage |
$244.47
|
| Rate for Payer: UHC Medicare Advantage |
$244.47
|
|
|
PR NERVE CONDUCTION STUDIES 1-2 STUDIES
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 95907
|
| Min. Negotiated Rate |
$66.80 |
| Max. Negotiated Rate |
$1,173.88 |
| Rate for Payer: Aetna Commercial |
$114.86
|
| Rate for Payer: Aetna Commercial |
$114.86
|
| Rate for Payer: Aetna Medicare |
$89.15
|
| Rate for Payer: Aetna Medicare |
$89.15
|
| Rate for Payer: BCBS Complete |
$66.80
|
| Rate for Payer: BCBS Complete |
$35.60
|
| Rate for Payer: BCBS MAPPO |
$85.72
|
| Rate for Payer: BCBS MAPPO |
$85.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,173.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,173.88
|
| Rate for Payer: BCN Commercial |
$130.48
|
| Rate for Payer: BCN Commercial |
$130.48
|
| Rate for Payer: BCN Medicare Advantage |
$85.72
|
| Rate for Payer: BCN Medicare Advantage |
$85.72
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$114.86
|
| Rate for Payer: Cofinity Commercial |
$123.44
|
| Rate for Payer: Cofinity Commercial |
$123.44
|
| Rate for Payer: Cofinity Commercial |
$114.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$90.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$90.01
|
| Rate for Payer: PACE SWMI |
$85.72
|
| Rate for Payer: PACE SWMI |
$85.72
|
| Rate for Payer: PHP Medicare Advantage |
$85.72
|
| Rate for Payer: PHP Medicare Advantage |
$85.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$119.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$119.92
|
| Rate for Payer: Priority Health Medicare |
$85.72
|
| Rate for Payer: Priority Health Medicare |
$85.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$119.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$119.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.72
|
| Rate for Payer: UHC Medicare Advantage |
$88.29
|
| Rate for Payer: UHC Medicare Advantage |
$88.29
|
|
|
PR NERVE CONDUCTION STUDIES 13/> STUDIES
|
Professional
|
Both
|
$524.00
|
|
|
Service Code
|
HCPCS 95913
|
| Min. Negotiated Rate |
$209.60 |
| Max. Negotiated Rate |
$415.86 |
| Rate for Payer: Aetna Commercial |
$367.63
|
| Rate for Payer: Aetna Commercial |
$367.63
|
| Rate for Payer: Aetna Medicare |
$285.32
|
| Rate for Payer: Aetna Medicare |
$285.32
|
| Rate for Payer: BCBS Complete |
$209.60
|
| Rate for Payer: BCBS Complete |
$344.00
|
| Rate for Payer: BCBS MAPPO |
$274.35
|
| Rate for Payer: BCBS MAPPO |
$274.35
|
| Rate for Payer: BCBS Trust/PPO |
$214.87
|
| Rate for Payer: BCBS Trust/PPO |
$214.87
|
| Rate for Payer: BCN Commercial |
$415.86
|
| Rate for Payer: BCN Commercial |
$415.86
|
| Rate for Payer: BCN Medicare Advantage |
$274.35
|
| Rate for Payer: BCN Medicare Advantage |
$274.35
|
| Rate for Payer: Cash Price |
$419.20
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Cash Price |
$419.20
|
| Rate for Payer: Cash Price |
$688.00
|
| Rate for Payer: Cofinity Commercial |
$395.06
|
| Rate for Payer: Cofinity Commercial |
$367.63
|
| Rate for Payer: Cofinity Commercial |
$395.06
|
| Rate for Payer: Cofinity Commercial |
$367.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$288.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$288.07
|
| Rate for Payer: PACE SWMI |
$274.35
|
| Rate for Payer: PACE SWMI |
$274.35
|
| Rate for Payer: PHP Medicare Advantage |
$274.35
|
| Rate for Payer: PHP Medicare Advantage |
$274.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$366.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$602.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$382.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$382.22
|
| Rate for Payer: Priority Health Medicare |
$274.35
|
| Rate for Payer: Priority Health Medicare |
$274.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$382.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$382.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$274.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$274.35
|
| Rate for Payer: UHC Medicare Advantage |
$282.58
|
| Rate for Payer: UHC Medicare Advantage |
$282.58
|
|
|
PR NERVE CONDUCTION STUDIES 3-4 STUDIES
|
Professional
|
Both
|
$214.00
|
|
|
Service Code
|
HCPCS 95908
|
| Min. Negotiated Rate |
$85.60 |
| Max. Negotiated Rate |
$1,235.69 |
| Rate for Payer: Aetna Commercial |
$142.76
|
| Rate for Payer: Aetna Commercial |
$142.76
|
| Rate for Payer: Aetna Medicare |
$110.80
|
| Rate for Payer: Aetna Medicare |
$110.80
|
| Rate for Payer: BCBS Complete |
$85.60
|
| Rate for Payer: BCBS Complete |
$132.80
|
| Rate for Payer: BCBS MAPPO |
$106.54
|
| Rate for Payer: BCBS MAPPO |
$106.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,235.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,235.69
|
| Rate for Payer: BCN Commercial |
$162.25
|
| Rate for Payer: BCN Commercial |
$162.25
|
| Rate for Payer: BCN Medicare Advantage |
$106.54
|
| Rate for Payer: BCN Medicare Advantage |
$106.54
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cofinity Commercial |
$153.42
|
| Rate for Payer: Cofinity Commercial |
$142.76
|
| Rate for Payer: Cofinity Commercial |
$142.76
|
| Rate for Payer: Cofinity Commercial |
$153.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$111.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$111.87
|
| Rate for Payer: PACE SWMI |
$106.54
|
| Rate for Payer: PACE SWMI |
$106.54
|
| Rate for Payer: PHP Medicare Advantage |
$106.54
|
| Rate for Payer: PHP Medicare Advantage |
$106.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$149.12
|
| Rate for Payer: Priority Health Medicare |
$106.54
|
| Rate for Payer: Priority Health Medicare |
$106.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.54
|
| Rate for Payer: UHC Medicare Advantage |
$109.74
|
| Rate for Payer: UHC Medicare Advantage |
$109.74
|
|
|
PR NERVE CONDUCTION STUDIES 5-6 STUDIES
|
Professional
|
Both
|
$398.00
|
|
|
Service Code
|
HCPCS 95909
|
| Min. Negotiated Rate |
$128.09 |
| Max. Negotiated Rate |
$1,003.24 |
| Rate for Payer: Aetna Commercial |
$171.64
|
| Rate for Payer: Aetna Commercial |
$171.64
|
| Rate for Payer: Aetna Medicare |
$133.21
|
| Rate for Payer: Aetna Medicare |
$133.21
|
| Rate for Payer: BCBS Complete |
$105.60
|
| Rate for Payer: BCBS Complete |
$159.20
|
| Rate for Payer: BCBS MAPPO |
$128.09
|
| Rate for Payer: BCBS MAPPO |
$128.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,003.24
|
| Rate for Payer: BCN Commercial |
$194.98
|
| Rate for Payer: BCN Commercial |
$194.98
|
| Rate for Payer: BCN Medicare Advantage |
$128.09
|
| Rate for Payer: BCN Medicare Advantage |
$128.09
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cofinity Commercial |
$184.45
|
| Rate for Payer: Cofinity Commercial |
$171.64
|
| Rate for Payer: Cofinity Commercial |
$171.64
|
| Rate for Payer: Cofinity Commercial |
$184.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$134.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$134.49
|
| Rate for Payer: PACE SWMI |
$128.09
|
| Rate for Payer: PACE SWMI |
$128.09
|
| Rate for Payer: PHP Medicare Advantage |
$128.09
|
| Rate for Payer: PHP Medicare Advantage |
$128.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.21
|
| Rate for Payer: Priority Health Medicare |
$128.09
|
| Rate for Payer: Priority Health Medicare |
$128.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$128.09
|
| Rate for Payer: UHC Medicare Advantage |
$131.93
|
| Rate for Payer: UHC Medicare Advantage |
$131.93
|
|
|
PR NERVE CONDUCTION STUDIES 7-8 STUDIES
|
Professional
|
Both
|
$524.00
|
|
|
Service Code
|
HCPCS 95910
|
| Min. Negotiated Rate |
$167.68 |
| Max. Negotiated Rate |
$1,982.71 |
| Rate for Payer: Aetna Commercial |
$224.69
|
| Rate for Payer: Aetna Commercial |
$224.69
|
| Rate for Payer: Aetna Medicare |
$174.39
|
| Rate for Payer: Aetna Medicare |
$174.39
|
| Rate for Payer: BCBS Complete |
$209.60
|
| Rate for Payer: BCBS Complete |
$149.60
|
| Rate for Payer: BCBS MAPPO |
$167.68
|
| Rate for Payer: BCBS MAPPO |
$167.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,982.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,982.71
|
| Rate for Payer: BCN Commercial |
$255.09
|
| Rate for Payer: BCN Commercial |
$255.09
|
| Rate for Payer: BCN Medicare Advantage |
$167.68
|
| Rate for Payer: BCN Medicare Advantage |
$167.68
|
| Rate for Payer: Cash Price |
$419.20
|
| Rate for Payer: Cash Price |
$419.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cofinity Commercial |
$241.46
|
| Rate for Payer: Cofinity Commercial |
$241.46
|
| Rate for Payer: Cofinity Commercial |
$224.69
|
| Rate for Payer: Cofinity Commercial |
$224.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$176.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$176.06
|
| Rate for Payer: PACE SWMI |
$167.68
|
| Rate for Payer: PACE SWMI |
$167.68
|
| Rate for Payer: PHP Medicare Advantage |
$167.68
|
| Rate for Payer: PHP Medicare Advantage |
$167.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$366.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.45
|
| Rate for Payer: Priority Health Medicare |
$167.68
|
| Rate for Payer: Priority Health Medicare |
$167.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$234.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$234.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.68
|
| Rate for Payer: UHC Medicare Advantage |
$172.71
|
| Rate for Payer: UHC Medicare Advantage |
$172.71
|
|
|
PR NERVE CONDUCTION STUDIES 9-10 STUDIES
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
HCPCS 95911
|
| Min. Negotiated Rate |
$177.60 |
| Max. Negotiated Rate |
$640.30 |
| Rate for Payer: Aetna Commercial |
$271.54
|
| Rate for Payer: Aetna Commercial |
$271.54
|
| Rate for Payer: Aetna Medicare |
$210.75
|
| Rate for Payer: Aetna Medicare |
$210.75
|
| Rate for Payer: BCBS Complete |
$253.60
|
| Rate for Payer: BCBS Complete |
$177.60
|
| Rate for Payer: BCBS MAPPO |
$202.64
|
| Rate for Payer: BCBS MAPPO |
$202.64
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCBS Trust/PPO |
$640.30
|
| Rate for Payer: BCN Commercial |
$307.87
|
| Rate for Payer: BCN Commercial |
$307.87
|
| Rate for Payer: BCN Medicare Advantage |
$202.64
|
| Rate for Payer: BCN Medicare Advantage |
$202.64
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$507.20
|
| Rate for Payer: Cofinity Commercial |
$271.54
|
| Rate for Payer: Cofinity Commercial |
$291.80
|
| Rate for Payer: Cofinity Commercial |
$271.54
|
| Rate for Payer: Cofinity Commercial |
$291.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$212.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$212.77
|
| Rate for Payer: PACE SWMI |
$202.64
|
| Rate for Payer: PACE SWMI |
$202.64
|
| Rate for Payer: PHP Medicare Advantage |
$202.64
|
| Rate for Payer: PHP Medicare Advantage |
$202.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$443.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$310.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.96
|
| Rate for Payer: Priority Health Medicare |
$202.64
|
| Rate for Payer: Priority Health Medicare |
$202.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$282.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$282.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$202.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$202.64
|
| Rate for Payer: UHC Medicare Advantage |
$208.72
|
| Rate for Payer: UHC Medicare Advantage |
$208.72
|
|
|
PR NERVE GRAFT 1 STRAND ARM/LEG <4 CM
|
Professional
|
Both
|
$2,105.00
|
|
|
Service Code
|
HCPCS 64892
|
| Min. Negotiated Rate |
$214.49 |
| Max. Negotiated Rate |
$1,779.08 |
| Rate for Payer: Aetna Commercial |
$1,387.21
|
| Rate for Payer: Aetna Medicare |
$1,076.64
|
| Rate for Payer: BCBS Complete |
$706.95
|
| Rate for Payer: BCBS MAPPO |
$1,035.23
|
| Rate for Payer: BCBS Trust/PPO |
$214.49
|
| Rate for Payer: BCN Commercial |
$1,535.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,035.23
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cash Price |
$1,684.00
|
| Rate for Payer: Cofinity Commercial |
$1,490.73
|
| Rate for Payer: Cofinity Commercial |
$1,387.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,035.23
|
| Rate for Payer: Mclaren Medicaid |
$673.29
|
| Rate for Payer: Meridian Medicaid |
$706.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,086.99
|
| Rate for Payer: PACE SWMI |
$1,035.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,035.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,473.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,779.08
|
| Rate for Payer: Priority Health Medicare |
$1,035.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,779.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,035.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,035.23
|
| Rate for Payer: UHC Medicare Advantage |
$1,066.29
|
|
|
PR NERVE GRAFT 1 STRAND ARM/LEG >4 CM
|
Professional
|
Both
|
$1,700.00
|
|
|
Service Code
|
HCPCS 64893
|
| Min. Negotiated Rate |
$605.43 |
| Max. Negotiated Rate |
$1,895.71 |
| Rate for Payer: Aetna Commercial |
$1,478.64
|
| Rate for Payer: Aetna Medicare |
$1,147.60
|
| Rate for Payer: BCBS Complete |
$753.48
|
| Rate for Payer: BCBS MAPPO |
$1,103.46
|
| Rate for Payer: BCBS Trust/PPO |
$605.43
|
| Rate for Payer: BCN Commercial |
$1,636.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,103.46
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cash Price |
$1,360.00
|
| Rate for Payer: Cofinity Commercial |
$1,478.64
|
| Rate for Payer: Cofinity Commercial |
$1,588.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,103.46
|
| Rate for Payer: Mclaren Medicaid |
$717.60
|
| Rate for Payer: Meridian Medicaid |
$753.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,158.63
|
| Rate for Payer: PACE SWMI |
$1,103.46
|
| Rate for Payer: PHP Medicare Advantage |
$1,103.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$717.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,190.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,895.71
|
| Rate for Payer: Priority Health Medicare |
$1,103.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,895.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,103.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,136.56
|
|
|
PR NERVE GRAFT 1 STRAND HAND/FOOT </4 CM
|
Professional
|
Both
|
$3,638.00
|
|
|
Service Code
|
HCPCS 64890
|
| Min. Negotiated Rate |
$359.24 |
| Max. Negotiated Rate |
$2,546.60 |
| Rate for Payer: Aetna Commercial |
$1,425.06
|
| Rate for Payer: Aetna Medicare |
$1,106.02
|
| Rate for Payer: BCBS Complete |
$726.19
|
| Rate for Payer: BCBS MAPPO |
$1,063.48
|
| Rate for Payer: BCBS Trust/PPO |
$359.24
|
| Rate for Payer: BCN Commercial |
$1,576.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,063.48
|
| Rate for Payer: Cash Price |
$2,910.40
|
| Rate for Payer: Cash Price |
$2,910.40
|
| Rate for Payer: Cofinity Commercial |
$1,531.41
|
| Rate for Payer: Cofinity Commercial |
$1,425.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,063.48
|
| Rate for Payer: Mclaren Medicaid |
$691.61
|
| Rate for Payer: Meridian Medicaid |
$726.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,116.65
|
| Rate for Payer: PACE SWMI |
$1,063.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,063.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$691.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,546.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,827.20
|
| Rate for Payer: Priority Health Medicare |
$1,063.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,827.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,063.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,063.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,095.38
|
|
|
PR NERVE GRAFT EACH NERVE MULTIPLE STRANDS
|
Professional
|
Both
|
$2,886.00
|
|
|
Service Code
|
HCPCS 64902
|
| Min. Negotiated Rate |
$379.32 |
| Max. Negotiated Rate |
$2,020.20 |
| Rate for Payer: Aetna Commercial |
$906.15
|
| Rate for Payer: Aetna Medicare |
$703.28
|
| Rate for Payer: BCBS Complete |
$454.90
|
| Rate for Payer: BCBS MAPPO |
$676.23
|
| Rate for Payer: BCBS Trust/PPO |
$379.32
|
| Rate for Payer: BCN Commercial |
$993.00
|
| Rate for Payer: BCN Medicare Advantage |
$676.23
|
| Rate for Payer: Cash Price |
$2,308.80
|
| Rate for Payer: Cash Price |
$2,308.80
|
| Rate for Payer: Cofinity Commercial |
$973.77
|
| Rate for Payer: Cofinity Commercial |
$906.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$676.23
|
| Rate for Payer: Mclaren Medicaid |
$433.24
|
| Rate for Payer: Meridian Medicaid |
$454.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$710.04
|
| Rate for Payer: PACE SWMI |
$676.23
|
| Rate for Payer: PHP Medicare Advantage |
$676.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$433.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,020.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,150.57
|
| Rate for Payer: Priority Health Medicare |
$676.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,150.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$676.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$676.23
|
| Rate for Payer: UHC Medicare Advantage |
$696.52
|
|
|
PR NERVE GRAFT MLT STRANDS ARM/LEG </4 CM
|
Professional
|
Both
|
$2,571.00
|
|
|
Service Code
|
HCPCS 64897
|
| Min. Negotiated Rate |
$407.32 |
| Max. Negotiated Rate |
$2,139.76 |
| Rate for Payer: Aetna Commercial |
$1,670.82
|
| Rate for Payer: Aetna Medicare |
$1,296.76
|
| Rate for Payer: BCBS Complete |
$850.09
|
| Rate for Payer: BCBS MAPPO |
$1,246.88
|
| Rate for Payer: BCBS Trust/PPO |
$407.32
|
| Rate for Payer: BCN Commercial |
$1,846.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,246.88
|
| Rate for Payer: Cash Price |
$2,056.80
|
| Rate for Payer: Cash Price |
$2,056.80
|
| Rate for Payer: Cofinity Commercial |
$1,670.82
|
| Rate for Payer: Cofinity Commercial |
$1,795.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,246.88
|
| Rate for Payer: Mclaren Medicaid |
$809.61
|
| Rate for Payer: Meridian Medicaid |
$850.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,309.22
|
| Rate for Payer: PACE SWMI |
$1,246.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,246.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$809.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,799.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,139.76
|
| Rate for Payer: Priority Health Medicare |
$1,246.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,139.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,246.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,246.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,284.29
|
|
|
PR NERVE GRAFT MLT STRANDS ARM/LEG >4 CM
|
Professional
|
Both
|
$3,128.00
|
|
|
Service Code
|
HCPCS 64898
|
| Min. Negotiated Rate |
$367.70 |
| Max. Negotiated Rate |
$2,316.43 |
| Rate for Payer: Aetna Commercial |
$1,808.71
|
| Rate for Payer: Aetna Medicare |
$1,403.77
|
| Rate for Payer: BCBS Complete |
$920.55
|
| Rate for Payer: BCBS MAPPO |
$1,349.78
|
| Rate for Payer: BCBS Trust/PPO |
$367.70
|
| Rate for Payer: BCN Commercial |
$1,999.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,349.78
|
| Rate for Payer: Cash Price |
$2,502.40
|
| Rate for Payer: Cash Price |
$2,502.40
|
| Rate for Payer: Cofinity Commercial |
$1,943.68
|
| Rate for Payer: Cofinity Commercial |
$1,808.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,349.78
|
| Rate for Payer: Mclaren Medicaid |
$876.71
|
| Rate for Payer: Meridian Medicaid |
$920.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,417.27
|
| Rate for Payer: PACE SWMI |
$1,349.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,349.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$876.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,189.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,316.43
|
| Rate for Payer: Priority Health Medicare |
$1,349.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,316.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,349.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,349.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,390.27
|
|
|
PR NERVE GRAFT MLT STRANDS HAND/FOOT </4 CM
|
Professional
|
Both
|
$3,152.00
|
|
|
Service Code
|
HCPCS 64895
|
| Min. Negotiated Rate |
$219.77 |
| Max. Negotiated Rate |
$2,239.42 |
| Rate for Payer: Aetna Commercial |
$1,749.36
|
| Rate for Payer: Aetna Medicare |
$1,357.71
|
| Rate for Payer: BCBS Complete |
$888.78
|
| Rate for Payer: BCBS MAPPO |
$1,305.49
|
| Rate for Payer: BCBS Trust/PPO |
$219.77
|
| Rate for Payer: BCN Commercial |
$1,932.72
|
| Rate for Payer: BCN Medicare Advantage |
$1,305.49
|
| Rate for Payer: Cash Price |
$2,521.60
|
| Rate for Payer: Cash Price |
$2,521.60
|
| Rate for Payer: Cofinity Commercial |
$1,879.91
|
| Rate for Payer: Cofinity Commercial |
$1,749.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,305.49
|
| Rate for Payer: Mclaren Medicaid |
$846.46
|
| Rate for Payer: Meridian Medicaid |
$888.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,370.76
|
| Rate for Payer: PACE SWMI |
$1,305.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,305.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,206.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,239.42
|
| Rate for Payer: Priority Health Medicare |
$1,305.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,239.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,305.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,305.49
|
| Rate for Payer: UHC Medicare Advantage |
$1,344.65
|
|
|
PR NERVE REPAIR W/CONDUIT EACH NERVE
|
Professional
|
Both
|
$2,570.00
|
|
|
Service Code
|
HCPCS 64910
|
| Min. Negotiated Rate |
$272.60 |
| Max. Negotiated Rate |
$1,799.00 |
| Rate for Payer: Aetna Commercial |
$998.06
|
| Rate for Payer: Aetna Medicare |
$774.61
|
| Rate for Payer: BCBS Complete |
$513.94
|
| Rate for Payer: BCBS MAPPO |
$744.82
|
| Rate for Payer: BCBS Trust/PPO |
$272.60
|
| Rate for Payer: BCN Commercial |
$1,113.21
|
| Rate for Payer: BCN Medicare Advantage |
$744.82
|
| Rate for Payer: Cash Price |
$2,056.00
|
| Rate for Payer: Cash Price |
$2,056.00
|
| Rate for Payer: Cofinity Commercial |
$998.06
|
| Rate for Payer: Cofinity Commercial |
$1,072.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$744.82
|
| Rate for Payer: Mclaren Medicaid |
$489.47
|
| Rate for Payer: Meridian Medicaid |
$513.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$782.06
|
| Rate for Payer: PACE SWMI |
$744.82
|
| Rate for Payer: PHP Medicare Advantage |
$744.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$489.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,799.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,289.86
|
| Rate for Payer: Priority Health Medicare |
$744.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,289.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$744.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$744.82
|
| Rate for Payer: UHC Medicare Advantage |
$767.16
|
|
|
PR NERVE REPAIR W/NERVE ALLOGRAFT EA ADDL STRAND
|
Professional
|
Both
|
$319.00
|
|
|
Service Code
|
HCPCS 64913
|
| Min. Negotiated Rate |
$109.06 |
| Max. Negotiated Rate |
$290.47 |
| Rate for Payer: Aetna Commercial |
$228.31
|
| Rate for Payer: Aetna Medicare |
$177.20
|
| Rate for Payer: BCBS Complete |
$114.51
|
| Rate for Payer: BCBS MAPPO |
$170.38
|
| Rate for Payer: BCBS Trust/PPO |
$274.19
|
| Rate for Payer: BCN Commercial |
$250.69
|
| Rate for Payer: BCN Medicare Advantage |
$170.38
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cofinity Commercial |
$245.35
|
| Rate for Payer: Cofinity Commercial |
$228.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.38
|
| Rate for Payer: Mclaren Medicaid |
$109.06
|
| Rate for Payer: Meridian Medicaid |
$114.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$178.90
|
| Rate for Payer: PACE SWMI |
$170.38
|
| Rate for Payer: PHP Medicare Advantage |
$170.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$109.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$290.47
|
| Rate for Payer: Priority Health Medicare |
$170.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$290.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.38
|
| Rate for Payer: UHC Medicare Advantage |
$175.49
|
|
|
PR NERVE REPAIR W/NERVE ALLOGRAFT FIRST STRAND
|
Professional
|
Both
|
$1,561.00
|
|
|
Service Code
|
HCPCS 64912
|
| Min. Negotiated Rate |
$311.17 |
| Max. Negotiated Rate |
$1,516.92 |
| Rate for Payer: Aetna Commercial |
$1,173.73
|
| Rate for Payer: Aetna Medicare |
$910.96
|
| Rate for Payer: BCBS Complete |
$602.96
|
| Rate for Payer: BCBS MAPPO |
$875.92
|
| Rate for Payer: BCBS Trust/PPO |
$311.17
|
| Rate for Payer: BCN Commercial |
$1,309.17
|
| Rate for Payer: BCN Medicare Advantage |
$875.92
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cash Price |
$1,248.80
|
| Rate for Payer: Cofinity Commercial |
$1,261.32
|
| Rate for Payer: Cofinity Commercial |
$1,173.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$875.92
|
| Rate for Payer: Mclaren Medicaid |
$574.25
|
| Rate for Payer: Meridian Medicaid |
$602.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$919.72
|
| Rate for Payer: PACE SWMI |
$875.92
|
| Rate for Payer: PHP Medicare Advantage |
$875.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$574.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,092.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,516.92
|
| Rate for Payer: Priority Health Medicare |
$875.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,516.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$875.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$875.92
|
| Rate for Payer: UHC Medicare Advantage |
$902.20
|
|
|
PR NEURAXIAL LABOR ANALG/ANES PLND VAGINAL DELIVERY
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS 01967
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$650.00 |
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$650.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$650.00
|
|
|
PR NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR
|
Professional
|
Both
|
$212.00
|
|
|
Service Code
|
HCPCS 96116
|
| Min. Negotiated Rate |
$50.48 |
| Max. Negotiated Rate |
$1,244.67 |
| Rate for Payer: Aetna Commercial |
$106.15
|
| Rate for Payer: Aetna Medicare |
$82.39
|
| Rate for Payer: BCBS Complete |
$53.00
|
| Rate for Payer: BCBS MAPPO |
$79.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,244.67
|
| Rate for Payer: BCN Commercial |
$134.38
|
| Rate for Payer: BCN Medicare Advantage |
$79.22
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cofinity Commercial |
$114.08
|
| Rate for Payer: Cofinity Commercial |
$106.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.22
|
| Rate for Payer: Mclaren Medicaid |
$50.48
|
| Rate for Payer: Meridian Medicaid |
$53.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$83.18
|
| Rate for Payer: PACE SWMI |
$79.22
|
| Rate for Payer: PHP Medicare Advantage |
$79.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.44
|
| Rate for Payer: Priority Health Medicare |
$79.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.22
|
| Rate for Payer: UHC Medicare Advantage |
$81.60
|
|
|
PR NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR
|
Professional
|
Both
|
$164.00
|
|
|
Service Code
|
HCPCS 96121
|
| Min. Negotiated Rate |
$41.96 |
| Max. Negotiated Rate |
$1,458.64 |
| Rate for Payer: Aetna Commercial |
$89.12
|
| Rate for Payer: Aetna Medicare |
$69.17
|
| Rate for Payer: BCBS Complete |
$44.06
|
| Rate for Payer: BCBS MAPPO |
$66.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,458.64
|
| Rate for Payer: BCN Commercial |
$109.46
|
| Rate for Payer: BCN Medicare Advantage |
$66.51
|
| Rate for Payer: Cash Price |
$131.20
|
| Rate for Payer: Cash Price |
$131.20
|
| Rate for Payer: Cofinity Commercial |
$89.12
|
| Rate for Payer: Cofinity Commercial |
$95.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.51
|
| Rate for Payer: Mclaren Medicaid |
$41.96
|
| Rate for Payer: Meridian Medicaid |
$44.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.84
|
| Rate for Payer: PACE SWMI |
$66.51
|
| Rate for Payer: PHP Medicare Advantage |
$66.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.93
|
| Rate for Payer: Priority Health Medicare |
$66.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.51
|
| Rate for Payer: UHC Medicare Advantage |
$68.51
|
|
|
PR NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY
|
Professional
|
Both
|
$4,301.50
|
|
|
Service Code
|
HCPCS 62164
|
| Min. Negotiated Rate |
$1,230.41 |
| Max. Negotiated Rate |
$4,290.63 |
| Rate for Payer: Aetna Commercial |
$2,826.40
|
| Rate for Payer: Aetna Medicare |
$2,193.62
|
| Rate for Payer: BCBS Complete |
$1,428.67
|
| Rate for Payer: BCBS MAPPO |
$2,109.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,230.41
|
| Rate for Payer: BCN Commercial |
$4,290.63
|
| Rate for Payer: BCN Medicare Advantage |
$2,109.25
|
| Rate for Payer: Cash Price |
$3,441.20
|
| Rate for Payer: Cash Price |
$3,441.20
|
| Rate for Payer: Cofinity Commercial |
$3,037.32
|
| Rate for Payer: Cofinity Commercial |
$2,826.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,109.25
|
| Rate for Payer: Mclaren Medicaid |
$1,360.64
|
| Rate for Payer: Meridian Medicaid |
$1,428.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,214.71
|
| Rate for Payer: PACE SWMI |
$2,109.25
|
| Rate for Payer: PHP Medicare Advantage |
$2,109.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,360.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,011.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,583.63
|
| Rate for Payer: Priority Health Medicare |
$2,109.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,583.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,109.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,109.25
|
| Rate for Payer: UHC Medicare Advantage |
$2,172.53
|
|
|
PR NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 95937
|
| Min. Negotiated Rate |
$59.17 |
| Max. Negotiated Rate |
$153.93 |
| Rate for Payer: Aetna Commercial |
$133.30
|
| Rate for Payer: Aetna Medicare |
$103.46
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCBS MAPPO |
$99.48
|
| Rate for Payer: BCBS Trust/PPO |
$59.17
|
| Rate for Payer: BCN Commercial |
$153.93
|
| Rate for Payer: BCN Medicare Advantage |
$99.48
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$133.30
|
| Rate for Payer: Cofinity Commercial |
$143.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$104.45
|
| Rate for Payer: PACE SWMI |
$99.48
|
| Rate for Payer: PHP Medicare Advantage |
$99.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.47
|
| Rate for Payer: Priority Health Medicare |
$99.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.48
|
| Rate for Payer: UHC Medicare Advantage |
$102.46
|
|
|
PR NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT
|
Professional
|
Both
|
$2,439.00
|
|
|
Service Code
|
HCPCS 64702
|
| Min. Negotiated Rate |
$333.77 |
| Max. Negotiated Rate |
$4,639.00 |
| Rate for Payer: Aetna Commercial |
$674.33
|
| Rate for Payer: Aetna Medicare |
$523.36
|
| Rate for Payer: BCBS Complete |
$350.46
|
| Rate for Payer: BCBS MAPPO |
$503.23
|
| Rate for Payer: BCBS Trust/PPO |
$4,639.00
|
| Rate for Payer: BCN Commercial |
$756.96
|
| Rate for Payer: BCN Medicare Advantage |
$503.23
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cash Price |
$1,951.20
|
| Rate for Payer: Cofinity Commercial |
$674.33
|
| Rate for Payer: Cofinity Commercial |
$724.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.23
|
| Rate for Payer: Mclaren Medicaid |
$333.77
|
| Rate for Payer: Meridian Medicaid |
$350.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$528.39
|
| Rate for Payer: PACE SWMI |
$503.23
|
| Rate for Payer: PHP Medicare Advantage |
$503.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,707.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$877.08
|
| Rate for Payer: Priority Health Medicare |
$503.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$877.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$503.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$503.23
|
| Rate for Payer: UHC Medicare Advantage |
$518.33
|
|
