|
PR DIR RPR RUPTD ANEURYSM & GRAFT ILIAC ARTERY
|
Professional
|
Both
|
$3,556.00
|
|
|
Service Code
|
HCPCS 35132
|
| Min. Negotiated Rate |
$947.42 |
| Max. Negotiated Rate |
$2,667.00 |
| Rate for Payer: Aetna Commercial |
$2,198.85
|
| Rate for Payer: Aetna Medicare |
$1,778.00
|
| Rate for Payer: BCBS Complete |
$994.79
|
| Rate for Payer: BCN Commercial |
$2,388.32
|
| Rate for Payer: Cash Price |
$2,844.80
|
| Rate for Payer: Cash Price |
$2,844.80
|
| Rate for Payer: Mclaren Medicaid |
$947.42
|
| Rate for Payer: Meridian Medicaid |
$994.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,667.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$947.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,568.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,568.34
|
| Rate for Payer: UHC Medicaid |
$947.42
|
| Rate for Payer: UHCCP Medicaid |
$947.42
|
|
|
PR DIR RPR RUPTD ANEURYSM & GRF COMMON FEMORAL ART
|
Professional
|
Both
|
$2,688.00
|
|
|
Service Code
|
HCPCS 35142
|
| Min. Negotiated Rate |
$761.90 |
| Max. Negotiated Rate |
$2,072.45 |
| Rate for Payer: Aetna Commercial |
$1,780.33
|
| Rate for Payer: Aetna Medicare |
$1,344.00
|
| Rate for Payer: BCBS Complete |
$800.00
|
| Rate for Payer: BCN Commercial |
$1,927.18
|
| Rate for Payer: Cash Price |
$2,150.40
|
| Rate for Payer: Cash Price |
$2,150.40
|
| Rate for Payer: Mclaren Medicaid |
$761.90
|
| Rate for Payer: Meridian Medicaid |
$800.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,016.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$761.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,072.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,072.45
|
| Rate for Payer: UHC Medicaid |
$761.90
|
| Rate for Payer: UHCCP Medicaid |
$761.90
|
|
|
PR DIR RPR RUPTD ANEURYSM & GRF POPLITEAL ARTERY
|
Professional
|
Both
|
$2,819.00
|
|
|
Service Code
|
HCPCS 35152
|
| Min. Negotiated Rate |
$810.47 |
| Max. Negotiated Rate |
$2,198.83 |
| Rate for Payer: Aetna Commercial |
$1,879.21
|
| Rate for Payer: Aetna Medicare |
$1,409.50
|
| Rate for Payer: BCBS Complete |
$850.99
|
| Rate for Payer: BCN Commercial |
$2,044.71
|
| Rate for Payer: Cash Price |
$2,255.20
|
| Rate for Payer: Cash Price |
$2,255.20
|
| Rate for Payer: Mclaren Medicaid |
$810.47
|
| Rate for Payer: Meridian Medicaid |
$850.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,114.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$810.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,198.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,198.83
|
| Rate for Payer: UHC Medicaid |
$810.47
|
| Rate for Payer: UHCCP Medicaid |
$810.47
|
|
|
PR DIR RPR RUPTD ANEURYSM INNOMINATE/SUBCLAVIAN
|
Professional
|
Both
|
$3,022.00
|
|
|
Service Code
|
HCPCS 35022
|
| Min. Negotiated Rate |
$877.35 |
| Max. Negotiated Rate |
$2,279.69 |
| Rate for Payer: Aetna Commercial |
$1,935.64
|
| Rate for Payer: Aetna Medicare |
$1,511.00
|
| Rate for Payer: BCBS Complete |
$921.22
|
| Rate for Payer: BCN Commercial |
$2,119.91
|
| Rate for Payer: Cash Price |
$2,417.60
|
| Rate for Payer: Cash Price |
$2,417.60
|
| Rate for Payer: Mclaren Medicaid |
$877.35
|
| Rate for Payer: Meridian Medicaid |
$921.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$877.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,279.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,279.69
|
| Rate for Payer: UHC Medicaid |
$877.35
|
| Rate for Payer: UHCCP Medicaid |
$877.35
|
|
|
PR DIR RPR RUPTD ANEURYSM RADIAL/ULNAR ARTERY
|
Professional
|
Both
|
$3,527.00
|
|
|
Service Code
|
HCPCS 35045
|
| Min. Negotiated Rate |
$555.50 |
| Max. Negotiated Rate |
$2,645.25 |
| Rate for Payer: Aetna Commercial |
$1,308.16
|
| Rate for Payer: Aetna Medicare |
$1,763.50
|
| Rate for Payer: BCBS Complete |
$583.27
|
| Rate for Payer: BCN Commercial |
$1,418.75
|
| Rate for Payer: Cash Price |
$2,821.60
|
| Rate for Payer: Cash Price |
$2,821.60
|
| Rate for Payer: Mclaren Medicaid |
$555.50
|
| Rate for Payer: Meridian Medicaid |
$583.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,645.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$555.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,525.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,525.68
|
| Rate for Payer: UHC Medicaid |
$555.50
|
| Rate for Payer: UHCCP Medicaid |
$555.50
|
|
|
PR DISARTICULATION HIP
|
Professional
|
Both
|
$5,595.00
|
|
|
Service Code
|
HCPCS 27295
|
| Min. Negotiated Rate |
$731.44 |
| Max. Negotiated Rate |
$4,196.25 |
| Rate for Payer: Aetna Commercial |
$1,675.17
|
| Rate for Payer: Aetna Medicare |
$2,797.50
|
| Rate for Payer: BCBS Complete |
$768.01
|
| Rate for Payer: BCN Commercial |
$1,891.83
|
| Rate for Payer: Cash Price |
$4,476.00
|
| Rate for Payer: Cash Price |
$4,476.00
|
| Rate for Payer: Mclaren Medicaid |
$731.44
|
| Rate for Payer: Meridian Medicaid |
$768.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,196.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$731.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,022.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,022.31
|
| Rate for Payer: UHC Medicaid |
$731.44
|
| Rate for Payer: UHCCP Medicaid |
$731.44
|
|
|
PR DISARTICULATION KNEE
|
Professional
|
Both
|
$3,021.00
|
|
|
Service Code
|
HCPCS 27598
|
| Min. Negotiated Rate |
$411.52 |
| Max. Negotiated Rate |
$2,265.75 |
| Rate for Payer: Aetna Commercial |
$947.37
|
| Rate for Payer: Aetna Medicare |
$1,510.50
|
| Rate for Payer: BCBS Complete |
$432.10
|
| Rate for Payer: BCN Commercial |
$1,044.76
|
| Rate for Payer: Cash Price |
$2,416.80
|
| Rate for Payer: Cash Price |
$2,416.80
|
| Rate for Payer: Mclaren Medicaid |
$411.52
|
| Rate for Payer: Meridian Medicaid |
$432.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,265.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$411.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,116.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,116.82
|
| Rate for Payer: UHC Medicaid |
$411.52
|
| Rate for Payer: UHCCP Medicaid |
$411.52
|
|
|
PR DISARTICULATION SHOULDER
|
Professional
|
Both
|
$2,056.00
|
|
|
Service Code
|
HCPCS 23920
|
| Min. Negotiated Rate |
$659.66 |
| Max. Negotiated Rate |
$1,821.63 |
| Rate for Payer: Aetna Commercial |
$1,500.60
|
| Rate for Payer: Aetna Medicare |
$1,028.00
|
| Rate for Payer: BCBS Complete |
$692.64
|
| Rate for Payer: BCN Commercial |
$1,704.09
|
| Rate for Payer: Cash Price |
$1,644.80
|
| Rate for Payer: Cash Price |
$1,644.80
|
| Rate for Payer: Mclaren Medicaid |
$659.66
|
| Rate for Payer: Meridian Medicaid |
$692.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,542.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$659.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,821.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,821.63
|
| Rate for Payer: UHC Medicaid |
$659.66
|
| Rate for Payer: UHCCP Medicaid |
$659.66
|
|
|
PR DISARTICULATION THROUGH WRIST
|
Professional
|
Both
|
$1,475.00
|
|
|
Service Code
|
HCPCS 25920
|
| Min. Negotiated Rate |
$444.74 |
| Max. Negotiated Rate |
$1,189.22 |
| Rate for Payer: Aetna Commercial |
$967.98
|
| Rate for Payer: Aetna Medicare |
$737.50
|
| Rate for Payer: BCBS Complete |
$466.98
|
| Rate for Payer: BCN Commercial |
$1,112.49
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Cash Price |
$1,180.00
|
| Rate for Payer: Mclaren Medicaid |
$444.74
|
| Rate for Payer: Meridian Medicaid |
$466.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,106.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,189.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,189.22
|
| Rate for Payer: UHC Medicaid |
$444.74
|
| Rate for Payer: UHCCP Medicaid |
$444.74
|
|
|
PR DISARTICULATION THRU WRIST RE-AMPUTATION
|
Professional
|
Both
|
$2,430.00
|
|
|
Service Code
|
HCPCS 25924
|
| Min. Negotiated Rate |
$434.73 |
| Max. Negotiated Rate |
$1,822.50 |
| Rate for Payer: Aetna Commercial |
$945.90
|
| Rate for Payer: Aetna Medicare |
$1,215.00
|
| Rate for Payer: BCBS Complete |
$456.47
|
| Rate for Payer: BCN Commercial |
$1,085.60
|
| Rate for Payer: Cash Price |
$1,944.00
|
| Rate for Payer: Cash Price |
$1,944.00
|
| Rate for Payer: Mclaren Medicaid |
$434.73
|
| Rate for Payer: Meridian Medicaid |
$456.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,822.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$434.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,160.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,160.47
|
| Rate for Payer: UHC Medicaid |
$434.73
|
| Rate for Payer: UHCCP Medicaid |
$434.73
|
|
|
PR DISCECTOMY ANT DCMPRN CORD CERVICAL 1 NTRSPC
|
Professional
|
Both
|
$5,918.00
|
|
|
Service Code
|
HCPCS 63075
|
| Min. Negotiated Rate |
$821.54 |
| Max. Negotiated Rate |
$4,438.50 |
| Rate for Payer: Aetna Commercial |
$1,752.58
|
| Rate for Payer: Aetna Medicare |
$2,959.00
|
| Rate for Payer: BCBS Complete |
$862.62
|
| Rate for Payer: BCN Commercial |
$2,259.94
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: Mclaren Medicaid |
$821.54
|
| Rate for Payer: Meridian Medicaid |
$862.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,438.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$821.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,389.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,389.35
|
| Rate for Payer: UHC Medicaid |
$821.54
|
| Rate for Payer: UHCCP Medicaid |
$821.54
|
|
|
PR DISCECTOMY ANT DCMPRN CORD CERVICAL EA NTRSPC
|
Professional
|
Both
|
$1,986.00
|
|
|
Service Code
|
HCPCS 63076
|
| Min. Negotiated Rate |
$138.45 |
| Max. Negotiated Rate |
$1,489.50 |
| Rate for Payer: Aetna Commercial |
$316.56
|
| Rate for Payer: Aetna Medicare |
$993.00
|
| Rate for Payer: BCBS Complete |
$145.37
|
| Rate for Payer: BCN Commercial |
$401.00
|
| Rate for Payer: Cash Price |
$1,588.80
|
| Rate for Payer: Cash Price |
$1,588.80
|
| Rate for Payer: Mclaren Medicaid |
$138.45
|
| Rate for Payer: Meridian Medicaid |
$145.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,489.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$423.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$423.96
|
| Rate for Payer: UHC Medicaid |
$138.45
|
| Rate for Payer: UHCCP Medicaid |
$138.45
|
|
|
PR DISCECTOMY ANT DCMPRN CORD THORACIC 1 NTRSPC
|
Professional
|
Both
|
$5,863.00
|
|
|
Service Code
|
HCPCS 63077
|
| Min. Negotiated Rate |
$836.45 |
| Max. Negotiated Rate |
$4,397.25 |
| Rate for Payer: Aetna Commercial |
$1,935.47
|
| Rate for Payer: Aetna Medicare |
$2,931.50
|
| Rate for Payer: BCBS Complete |
$878.27
|
| Rate for Payer: BCN Commercial |
$2,420.78
|
| Rate for Payer: Cash Price |
$4,690.40
|
| Rate for Payer: Cash Price |
$4,690.40
|
| Rate for Payer: Mclaren Medicaid |
$836.45
|
| Rate for Payer: Meridian Medicaid |
$878.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,397.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,559.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,559.40
|
| Rate for Payer: UHC Medicaid |
$836.45
|
| Rate for Payer: UHCCP Medicaid |
$836.45
|
|
|
PR DISCHRG MEDS RECONCILED W/CURRENT MED LIST
|
Professional
|
Both
|
$0.01
|
|
|
Service Code
|
HCPCS 1111F
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.01
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
|
|
PR DISEASE MANAGEMENT PROGRAM
|
Professional
|
Both
|
$473.00
|
|
|
Service Code
|
HCPCS S0315
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$354.75 |
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: Aetna Medicare |
$236.50
|
| Rate for Payer: BCBS Complete |
$189.20
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Cash Price |
$378.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.75
|
|
|
PR DISEASE MGMT PER DIEM
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS S0317
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$1,000.00 |
| Rate for Payer: Aetna Commercial |
$175.00
|
| Rate for Payer: Aetna Commercial |
$175.00
|
| Rate for Payer: Aetna Medicare |
$79.00
|
| Rate for Payer: Aetna Medicare |
$52.50
|
| Rate for Payer: BCBS Complete |
$42.00
|
| Rate for Payer: BCBS Complete |
$63.20
|
| Rate for Payer: BCN Commercial |
$1,000.00
|
| Rate for Payer: BCN Commercial |
$1,000.00
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
|
|
PR DISE DYN EVAL SLEEP DISORDERED BREATHING FLX DX
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 42975
|
| Min. Negotiated Rate |
$53.25 |
| Max. Negotiated Rate |
$177.17 |
| Rate for Payer: Aetna Commercial |
$150.00
|
| Rate for Payer: Aetna Medicare |
$117.00
|
| Rate for Payer: BCBS Complete |
$55.91
|
| Rate for Payer: BCN Commercial |
$145.41
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Mclaren Medicaid |
$53.25
|
| Rate for Payer: Meridian Medicaid |
$55.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$175.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$177.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.17
|
| Rate for Payer: UHC Medicaid |
$53.25
|
| Rate for Payer: UHCCP Medicaid |
$53.25
|
|
|
PR DISPENSING FEE BINAURAL
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS V5160
|
| Min. Negotiated Rate |
$200.00 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$289.59
|
| Rate for Payer: Aetna Medicare |
$250.00
|
| Rate for Payer: BCBS Complete |
$200.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.00
|
|
|
PR DISPENSING FEE, MONAURAL
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS V5241
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$216.75 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$144.50
|
| Rate for Payer: BCBS Complete |
$115.60
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.75
|
|
|
PR DISP FEE CONTRALATERAL BINAU
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS V5240
|
| Min. Negotiated Rate |
$200.00 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$248.26
|
| Rate for Payer: Aetna Medicare |
$250.00
|
| Rate for Payer: BCBS Complete |
$200.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.00
|
|
|
PR DISP FEE CONTRALATERAL MONAU
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS V5200
|
| Min. Negotiated Rate |
$115.60 |
| Max. Negotiated Rate |
$239.68 |
| Rate for Payer: Aetna Commercial |
$239.68
|
| Rate for Payer: Aetna Medicare |
$144.50
|
| Rate for Payer: BCBS Complete |
$115.60
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$216.75
|
|
|
PR DISSECTION DEEP JUGULAR NODE
|
Professional
|
Both
|
$966.00
|
|
|
Service Code
|
HCPCS 38542
|
| Min. Negotiated Rate |
$299.48 |
| Max. Negotiated Rate |
$1,050.90 |
| Rate for Payer: Aetna Commercial |
$636.69
|
| Rate for Payer: Aetna Medicare |
$483.00
|
| Rate for Payer: BCBS Complete |
$314.45
|
| Rate for Payer: BCN Commercial |
$789.79
|
| Rate for Payer: Cash Price |
$772.80
|
| Rate for Payer: Cash Price |
$772.80
|
| Rate for Payer: Mclaren Medicaid |
$299.48
|
| Rate for Payer: Meridian Medicaid |
$314.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$724.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$299.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,050.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,050.90
|
| Rate for Payer: UHC Medicaid |
$299.48
|
| Rate for Payer: UHCCP Medicaid |
$299.48
|
|
|
PR DIS SITE TELE SVCS RHC/FQHC
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS G2025
|
| Min. Negotiated Rate |
$77.60 |
| Max. Negotiated Rate |
$145.50 |
| Rate for Payer: Aetna Commercial |
$95.30
|
| Rate for Payer: Aetna Medicare |
$97.00
|
| Rate for Payer: BCBS Complete |
$77.60
|
| Rate for Payer: BCN Commercial |
$145.41
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.50
|
|
|
PR DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD
|
Professional
|
Both
|
$89.00
|
|
|
Service Code
|
HCPCS 92587
|
| Min. Negotiated Rate |
$24.41 |
| Max. Negotiated Rate |
$66.75 |
| Rate for Payer: Aetna Commercial |
$24.41
|
| Rate for Payer: Aetna Medicare |
$44.50
|
| Rate for Payer: BCN Commercial |
$32.37
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$29.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.86
|
|
|
PR DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL
|
Professional
|
Both
|
$71.00
|
|
|
Service Code
|
HCPCS 92588
|
| Min. Negotiated Rate |
$35.50 |
| Max. Negotiated Rate |
$53.25 |
| Rate for Payer: Aetna Commercial |
$37.21
|
| Rate for Payer: Aetna Medicare |
$35.50
|
| Rate for Payer: BCN Commercial |
$49.80
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.93
|
|
