|
PR EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR
|
Professional
|
Both
|
$1,524.00
|
|
|
Service Code
|
HCPCS 35860
|
| Min. Negotiated Rate |
$531.44 |
| Max. Negotiated Rate |
$1,318.92 |
| Rate for Payer: Aetna Commercial |
$1,085.69
|
| Rate for Payer: Aetna Medicare |
$842.63
|
| Rate for Payer: BCBS Complete |
$558.01
|
| Rate for Payer: BCBS MAPPO |
$810.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,072.45
|
| Rate for Payer: BCN Commercial |
$1,204.10
|
| Rate for Payer: BCN Medicare Advantage |
$810.22
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cash Price |
$1,219.20
|
| Rate for Payer: Cofinity Commercial |
$1,166.72
|
| Rate for Payer: Cofinity Commercial |
$1,085.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.22
|
| Rate for Payer: Mclaren Medicaid |
$531.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$850.73
|
| Rate for Payer: Meridian Medicaid |
$558.01
|
| Rate for Payer: Nomi Health Commercial |
$972.26
|
| Rate for Payer: PACE SWMI |
$810.22
|
| Rate for Payer: PHP Medicare Advantage |
$810.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$990.60
|
| Rate for Payer: Priority Health HMO/PPO |
$1,318.92
|
| Rate for Payer: Priority Health Medicare |
$818.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,318.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$810.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.22
|
| Rate for Payer: UHC Exchange |
$810.22
|
| Rate for Payer: UHC Medicare Advantage |
$810.22
|
| Rate for Payer: UHCCP Medicaid |
$531.44
|
|
|
PR EXPL RETROPERITONEUM W/WO BX SPX
|
Professional
|
Both
|
$2,032.00
|
|
|
Service Code
|
HCPCS 49010
|
| Min. Negotiated Rate |
$588.53 |
| Max. Negotiated Rate |
$1,647.20 |
| Rate for Payer: Aetna Commercial |
$1,204.75
|
| Rate for Payer: Aetna Medicare |
$935.03
|
| Rate for Payer: BCBS Complete |
$623.09
|
| Rate for Payer: BCBS MAPPO |
$899.07
|
| Rate for Payer: BCBS Trust/PPO |
$588.53
|
| Rate for Payer: BCN Commercial |
$1,340.45
|
| Rate for Payer: BCN Medicare Advantage |
$899.07
|
| Rate for Payer: Cash Price |
$1,625.60
|
| Rate for Payer: Cash Price |
$1,625.60
|
| Rate for Payer: Cofinity Commercial |
$1,294.66
|
| Rate for Payer: Cofinity Commercial |
$1,204.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$899.07
|
| Rate for Payer: Mclaren Medicaid |
$593.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$944.02
|
| Rate for Payer: Meridian Medicaid |
$623.09
|
| Rate for Payer: Nomi Health Commercial |
$1,078.88
|
| Rate for Payer: PACE SWMI |
$899.07
|
| Rate for Payer: PHP Medicare Advantage |
$899.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$593.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.80
|
| Rate for Payer: Priority Health HMO/PPO |
$1,647.20
|
| Rate for Payer: Priority Health Medicare |
$908.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,647.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$899.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$899.07
|
| Rate for Payer: UHC Exchange |
$899.07
|
| Rate for Payer: UHC Medicare Advantage |
$899.07
|
| Rate for Payer: UHCCP Medicaid |
$593.42
|
|
|
PR EXPL RPR & PRESACRAL DRG RECTAL INJURY
|
Professional
|
Both
|
$3,078.00
|
|
|
Service Code
|
HCPCS 45562
|
| Min. Negotiated Rate |
$753.59 |
| Max. Negotiated Rate |
$2,095.24 |
| Rate for Payer: Aetna Commercial |
$1,518.41
|
| Rate for Payer: Aetna Medicare |
$1,178.47
|
| Rate for Payer: BCBS Complete |
$791.27
|
| Rate for Payer: BCBS MAPPO |
$1,133.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,130.03
|
| Rate for Payer: BCN Commercial |
$1,652.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,133.14
|
| Rate for Payer: Cash Price |
$2,462.40
|
| Rate for Payer: Cash Price |
$2,462.40
|
| Rate for Payer: Cofinity Commercial |
$1,631.72
|
| Rate for Payer: Cofinity Commercial |
$1,518.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,133.14
|
| Rate for Payer: Mclaren Medicaid |
$753.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,189.80
|
| Rate for Payer: Meridian Medicaid |
$791.27
|
| Rate for Payer: Nomi Health Commercial |
$1,359.77
|
| Rate for Payer: PACE SWMI |
$1,133.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,133.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$753.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,000.70
|
| Rate for Payer: Priority Health HMO/PPO |
$2,095.24
|
| Rate for Payer: Priority Health Medicare |
$1,144.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,095.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,133.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,133.14
|
| Rate for Payer: UHC Exchange |
$1,133.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,133.14
|
| Rate for Payer: UHCCP Medicaid |
$753.59
|
|
|
PR EXPL UNDESCENDED TESTIS W/ABDOMINAL EXPL
|
Professional
|
Both
|
$1,299.00
|
|
|
Service Code
|
HCPCS 54560
|
| Min. Negotiated Rate |
$440.91 |
| Max. Negotiated Rate |
$3,980.21 |
| Rate for Payer: Aetna Commercial |
$880.74
|
| Rate for Payer: Aetna Medicare |
$683.56
|
| Rate for Payer: BCBS Complete |
$462.96
|
| Rate for Payer: BCBS MAPPO |
$657.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,980.21
|
| Rate for Payer: BCN Commercial |
$993.00
|
| Rate for Payer: BCN Medicare Advantage |
$657.27
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cofinity Commercial |
$946.47
|
| Rate for Payer: Cofinity Commercial |
$880.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$657.27
|
| Rate for Payer: Mclaren Medicaid |
$440.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$690.13
|
| Rate for Payer: Meridian Medicaid |
$462.96
|
| Rate for Payer: Nomi Health Commercial |
$788.72
|
| Rate for Payer: PACE SWMI |
$657.27
|
| Rate for Payer: PHP Medicare Advantage |
$657.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$844.35
|
| Rate for Payer: Priority Health HMO/PPO |
$1,095.55
|
| Rate for Payer: Priority Health Medicare |
$663.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,095.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$657.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$657.27
|
| Rate for Payer: UHC Exchange |
$657.27
|
| Rate for Payer: UHC Medicare Advantage |
$657.27
|
| Rate for Payer: UHCCP Medicaid |
$440.91
|
|
|
PR EXPL UNDESCENDED TSTIS INGUN/SCROTAL AREA
|
Professional
|
Both
|
$928.00
|
|
|
Service Code
|
HCPCS 54550
|
| Min. Negotiated Rate |
$316.52 |
| Max. Negotiated Rate |
$2,742.41 |
| Rate for Payer: Aetna Commercial |
$630.79
|
| Rate for Payer: Aetna Medicare |
$489.57
|
| Rate for Payer: BCBS Complete |
$332.35
|
| Rate for Payer: BCBS MAPPO |
$470.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,742.41
|
| Rate for Payer: BCN Commercial |
$711.03
|
| Rate for Payer: BCN Medicare Advantage |
$470.74
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Cash Price |
$742.40
|
| Rate for Payer: Cofinity Commercial |
$677.87
|
| Rate for Payer: Cofinity Commercial |
$630.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$470.74
|
| Rate for Payer: Mclaren Medicaid |
$316.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$494.28
|
| Rate for Payer: Meridian Medicaid |
$332.35
|
| Rate for Payer: Nomi Health Commercial |
$564.89
|
| Rate for Payer: PACE SWMI |
$470.74
|
| Rate for Payer: PHP Medicare Advantage |
$470.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$603.20
|
| Rate for Payer: Priority Health HMO/PPO |
$786.66
|
| Rate for Payer: Priority Health Medicare |
$475.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$786.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$470.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$470.74
|
| Rate for Payer: UHC Exchange |
$470.74
|
| Rate for Payer: UHC Medicare Advantage |
$470.74
|
| Rate for Payer: UHCCP Medicaid |
$316.52
|
|
|
PR EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST
|
Professional
|
Both
|
$820.00
|
|
|
Service Code
|
HCPCS 25248
|
| Min. Negotiated Rate |
$274.77 |
| Max. Negotiated Rate |
$1,918.26 |
| Rate for Payer: Aetna Commercial |
$542.12
|
| Rate for Payer: Aetna Medicare |
$420.75
|
| Rate for Payer: BCBS Complete |
$288.51
|
| Rate for Payer: BCBS MAPPO |
$404.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,918.26
|
| Rate for Payer: BCN Commercial |
$615.74
|
| Rate for Payer: BCN Medicare Advantage |
$404.57
|
| Rate for Payer: Cash Price |
$656.00
|
| Rate for Payer: Cash Price |
$656.00
|
| Rate for Payer: Cofinity Commercial |
$582.58
|
| Rate for Payer: Cofinity Commercial |
$542.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.57
|
| Rate for Payer: Mclaren Medicaid |
$274.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$424.80
|
| Rate for Payer: Meridian Medicaid |
$288.51
|
| Rate for Payer: Nomi Health Commercial |
$485.48
|
| Rate for Payer: PACE SWMI |
$404.57
|
| Rate for Payer: PHP Medicare Advantage |
$404.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.00
|
| Rate for Payer: Priority Health HMO/PPO |
$662.53
|
| Rate for Payer: Priority Health Medicare |
$408.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$662.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$404.57
|
| Rate for Payer: UHC Exchange |
$404.57
|
| Rate for Payer: UHC Medicare Advantage |
$404.57
|
| Rate for Payer: UHCCP Medicaid |
$274.77
|
|
|
PR EXPOS PROSTATE ANY APPROACH INSJ RADIOACT SUBST
|
Professional
|
Both
|
$1,673.00
|
|
|
Service Code
|
HCPCS 55860
|
| Min. Negotiated Rate |
$558.91 |
| Max. Negotiated Rate |
$2,253.73 |
| Rate for Payer: Aetna Commercial |
$1,118.93
|
| Rate for Payer: Aetna Medicare |
$868.42
|
| Rate for Payer: BCBS Complete |
$586.86
|
| Rate for Payer: BCBS MAPPO |
$835.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,253.73
|
| Rate for Payer: BCN Commercial |
$1,260.78
|
| Rate for Payer: BCN Medicare Advantage |
$835.02
|
| Rate for Payer: Cash Price |
$1,338.40
|
| Rate for Payer: Cash Price |
$1,338.40
|
| Rate for Payer: Cofinity Commercial |
$1,202.43
|
| Rate for Payer: Cofinity Commercial |
$1,118.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$835.02
|
| Rate for Payer: Mclaren Medicaid |
$558.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$876.77
|
| Rate for Payer: Meridian Medicaid |
$586.86
|
| Rate for Payer: Nomi Health Commercial |
$1,002.02
|
| Rate for Payer: PACE SWMI |
$835.02
|
| Rate for Payer: PHP Medicare Advantage |
$835.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$558.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,087.45
|
| Rate for Payer: Priority Health HMO/PPO |
$1,388.50
|
| Rate for Payer: Priority Health Medicare |
$843.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,388.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$835.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$835.02
|
| Rate for Payer: UHC Exchange |
$835.02
|
| Rate for Payer: UHC Medicare Advantage |
$835.02
|
| Rate for Payer: UHCCP Medicaid |
$558.91
|
|
|
PR EXPRESS FACIAL REFINEMENT OR RELAXATION
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 00126
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$99.45 |
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
|
|
PR EXT ECG > 48HR TO 21 DAY RCRD W/CONECT INTL RCRD
|
Professional
|
Both
|
$189.00
|
|
|
Service Code
|
HCPCS 0296T
|
| Min. Negotiated Rate |
$75.60 |
| Max. Negotiated Rate |
$122.85 |
| Rate for Payer: Aetna Medicare |
$94.50
|
| Rate for Payer: BCBS Complete |
$75.60
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.85
|
|
|
PR EXT ECG > 48HR TO 21 DAY REVIEW AND INTERPRETATN
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 0298T
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
|
|
PR EXTENDED ABDOMINOPLASTY
|
Professional
|
Both
|
$5,304.00
|
|
|
Service Code
|
HCPCS 00366
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2,121.60 |
| Max. Negotiated Rate |
$3,447.60 |
| Rate for Payer: Aetna Medicare |
$2,652.00
|
| Rate for Payer: BCBS Complete |
$2,121.60
|
| Rate for Payer: Cash Price |
$4,243.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,447.60
|
|
|
PR EXTENDED VISUAL FIELD XM UNI/BI I&R
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 92083
|
| Min. Negotiated Rate |
$16.83 |
| Max. Negotiated Rate |
$1,352.98 |
| Rate for Payer: Aetna Commercial |
$76.78
|
| Rate for Payer: Aetna Medicare |
$59.59
|
| Rate for Payer: BCBS Complete |
$17.67
|
| Rate for Payer: BCBS MAPPO |
$57.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,352.98
|
| Rate for Payer: BCN Commercial |
$90.89
|
| Rate for Payer: BCN Medicare Advantage |
$57.30
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$82.51
|
| Rate for Payer: Cofinity Commercial |
$76.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.30
|
| Rate for Payer: Mclaren Medicaid |
$16.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.16
|
| Rate for Payer: Meridian Medicaid |
$17.67
|
| Rate for Payer: Nomi Health Commercial |
$68.76
|
| Rate for Payer: PACE SWMI |
$57.30
|
| Rate for Payer: PHP Medicare Advantage |
$57.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health HMO/PPO |
$45.37
|
| Rate for Payer: Priority Health Medicare |
$57.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.30
|
| Rate for Payer: UHC Exchange |
$57.30
|
| Rate for Payer: UHC Medicare Advantage |
$57.30
|
| Rate for Payer: UHCCP Medicaid |
$16.83
|
|
|
PR EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 59412
|
| Min. Negotiated Rate |
$95.36 |
| Max. Negotiated Rate |
$279.47 |
| Rate for Payer: Aetna Commercial |
$134.51
|
| Rate for Payer: Aetna Medicare |
$104.40
|
| Rate for Payer: BCBS Complete |
$100.13
|
| Rate for Payer: BCBS MAPPO |
$100.38
|
| Rate for Payer: BCBS Trust/PPO |
$279.47
|
| Rate for Payer: BCN Commercial |
$150.03
|
| Rate for Payer: BCN Medicare Advantage |
$100.38
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$144.55
|
| Rate for Payer: Cofinity Commercial |
$134.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.38
|
| Rate for Payer: Mclaren Medicaid |
$95.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.40
|
| Rate for Payer: Meridian Medicaid |
$100.13
|
| Rate for Payer: Nomi Health Commercial |
$120.46
|
| Rate for Payer: PACE SWMI |
$100.38
|
| Rate for Payer: PHP Medicare Advantage |
$100.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.50
|
| Rate for Payer: Priority Health HMO/PPO |
$143.92
|
| Rate for Payer: Priority Health Medicare |
$101.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$143.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.38
|
| Rate for Payer: UHC Exchange |
$100.38
|
| Rate for Payer: UHC Medicare Advantage |
$100.38
|
| Rate for Payer: UHCCP Medicaid |
$95.36
|
|
|
PR EXTERNAL DRAINAGE PSEUDOCYST OF PANCREAS OPEN
|
Professional
|
Both
|
$3,081.00
|
|
|
Service Code
|
HCPCS 48510
|
| Min. Negotiated Rate |
$250.41 |
| Max. Negotiated Rate |
$2,002.65 |
| Rate for Payer: Aetna Commercial |
$1,425.14
|
| Rate for Payer: Aetna Medicare |
$1,106.08
|
| Rate for Payer: BCBS Complete |
$741.40
|
| Rate for Payer: BCBS MAPPO |
$1,063.54
|
| Rate for Payer: BCBS Trust/PPO |
$250.41
|
| Rate for Payer: BCN Commercial |
$1,605.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,063.54
|
| Rate for Payer: Cash Price |
$2,464.80
|
| Rate for Payer: Cash Price |
$2,464.80
|
| Rate for Payer: Cofinity Commercial |
$1,531.50
|
| Rate for Payer: Cofinity Commercial |
$1,425.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,063.54
|
| Rate for Payer: Mclaren Medicaid |
$706.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,116.72
|
| Rate for Payer: Meridian Medicaid |
$741.40
|
| Rate for Payer: Nomi Health Commercial |
$1,276.25
|
| Rate for Payer: PACE SWMI |
$1,063.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,063.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$706.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,002.65
|
| Rate for Payer: Priority Health HMO/PPO |
$1,967.56
|
| Rate for Payer: Priority Health Medicare |
$1,074.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,967.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,063.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,063.54
|
| Rate for Payer: UHC Exchange |
$1,063.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,063.54
|
| Rate for Payer: UHCCP Medicaid |
$706.10
|
|
|
PR EXTERNAL ECG REC>48HR<7D RECORDING
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 93242
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$526.19 |
| Rate for Payer: Aetna Commercial |
$13.94
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$526.19
|
| Rate for Payer: BCN Commercial |
$14.13
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$14.98
|
| Rate for Payer: Cofinity Commercial |
$13.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.92
|
| Rate for Payer: Nomi Health Commercial |
$12.48
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health HMO/PPO |
$16.95
|
| Rate for Payer: Priority Health Medicare |
$10.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
|
|
PR EXTERNAL ECG REC>48HR<7D REVIEW & INTERPRETATION
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 93244
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$533.05 |
| Rate for Payer: Aetna Commercial |
$29.01
|
| Rate for Payer: Aetna Medicare |
$22.52
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$21.65
|
| Rate for Payer: BCBS Trust/PPO |
$533.05
|
| Rate for Payer: BCN Commercial |
$27.09
|
| Rate for Payer: BCN Medicare Advantage |
$21.65
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$29.01
|
| Rate for Payer: Cofinity Commercial |
$31.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.65
|
| Rate for Payer: Mclaren Medicaid |
$14.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.73
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Nomi Health Commercial |
$25.98
|
| Rate for Payer: PACE SWMI |
$21.65
|
| Rate for Payer: PHP Medicare Advantage |
$21.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.85
|
| Rate for Payer: Priority Health HMO/PPO |
$32.02
|
| Rate for Payer: Priority Health Medicare |
$21.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.65
|
| Rate for Payer: UHC Exchange |
$21.65
|
| Rate for Payer: UHC Medicare Advantage |
$21.65
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
|
|
PR EXTERNAL ECG REC>7D<15D RECORDING
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 93246
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$607.55 |
| Rate for Payer: Aetna Commercial |
$13.94
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$607.55
|
| Rate for Payer: BCN Commercial |
$14.13
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$14.98
|
| Rate for Payer: Cofinity Commercial |
$13.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.92
|
| Rate for Payer: Nomi Health Commercial |
$12.48
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health HMO/PPO |
$16.95
|
| Rate for Payer: Priority Health Medicare |
$10.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
|
|
PR EXTERNAL ECG REC>7D<15D REVIEW & INTERPRETATION
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 93248
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$892.83 |
| Rate for Payer: Aetna Commercial |
$31.96
|
| Rate for Payer: Aetna Medicare |
$24.80
|
| Rate for Payer: BCBS Complete |
$16.78
|
| Rate for Payer: BCBS MAPPO |
$23.85
|
| Rate for Payer: BCBS Trust/PPO |
$892.83
|
| Rate for Payer: BCN Commercial |
$29.84
|
| Rate for Payer: BCN Medicare Advantage |
$23.85
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$31.96
|
| Rate for Payer: Cofinity Commercial |
$34.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.85
|
| Rate for Payer: Mclaren Medicaid |
$15.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.04
|
| Rate for Payer: Meridian Medicaid |
$16.78
|
| Rate for Payer: Nomi Health Commercial |
$28.62
|
| Rate for Payer: PACE SWMI |
$23.85
|
| Rate for Payer: PHP Medicare Advantage |
$23.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health HMO/PPO |
$35.32
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.85
|
| Rate for Payer: UHC Exchange |
$23.85
|
| Rate for Payer: UHC Medicare Advantage |
$23.85
|
| Rate for Payer: UHCCP Medicaid |
$15.98
|
|
|
PR EXTRAPLEURAL ENUCLEATION EMPYEMA EMPYEMECTOMY
|
Professional
|
Both
|
$3,216.00
|
|
|
Service Code
|
HCPCS 32540
|
| Min. Negotiated Rate |
$1,090.77 |
| Max. Negotiated Rate |
$2,481.51 |
| Rate for Payer: Aetna Commercial |
$2,223.23
|
| Rate for Payer: Aetna Medicare |
$1,725.50
|
| Rate for Payer: BCBS Complete |
$1,145.31
|
| Rate for Payer: BCBS MAPPO |
$1,659.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,336.07
|
| Rate for Payer: BCN Commercial |
$2,481.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,659.13
|
| Rate for Payer: Cash Price |
$2,572.80
|
| Rate for Payer: Cash Price |
$2,572.80
|
| Rate for Payer: Cofinity Commercial |
$2,389.15
|
| Rate for Payer: Cofinity Commercial |
$2,223.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,659.13
|
| Rate for Payer: Mclaren Medicaid |
$1,090.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,742.09
|
| Rate for Payer: Meridian Medicaid |
$1,145.31
|
| Rate for Payer: Nomi Health Commercial |
$1,990.96
|
| Rate for Payer: PACE SWMI |
$1,659.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,659.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,090.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,090.40
|
| Rate for Payer: Priority Health HMO/PPO |
$2,367.39
|
| Rate for Payer: Priority Health Medicare |
$1,675.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,367.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,659.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,659.13
|
| Rate for Payer: UHC Exchange |
$1,659.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,659.13
|
| Rate for Payer: UHCCP Medicaid |
$1,090.77
|
|
|
PR EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5CM/>
|
Professional
|
Both
|
$1,204.00
|
|
|
Service Code
|
HCPCS 26111
|
| Min. Negotiated Rate |
$210.98 |
| Max. Negotiated Rate |
$782.60 |
| Rate for Payer: Aetna Commercial |
$540.01
|
| Rate for Payer: Aetna Medicare |
$419.11
|
| Rate for Payer: BCBS Complete |
$287.40
|
| Rate for Payer: BCBS MAPPO |
$402.99
|
| Rate for Payer: BCBS Trust/PPO |
$210.98
|
| Rate for Payer: BCN Commercial |
$613.77
|
| Rate for Payer: BCN Medicare Advantage |
$402.99
|
| Rate for Payer: Cash Price |
$963.20
|
| Rate for Payer: Cash Price |
$963.20
|
| Rate for Payer: Cofinity Commercial |
$580.31
|
| Rate for Payer: Cofinity Commercial |
$540.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$402.99
|
| Rate for Payer: Mclaren Medicaid |
$273.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.14
|
| Rate for Payer: Meridian Medicaid |
$287.40
|
| Rate for Payer: Nomi Health Commercial |
$483.59
|
| Rate for Payer: PACE SWMI |
$402.99
|
| Rate for Payer: PHP Medicare Advantage |
$402.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$273.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.60
|
| Rate for Payer: Priority Health HMO/PPO |
$646.76
|
| Rate for Payer: Priority Health Medicare |
$407.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$646.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$402.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$402.99
|
| Rate for Payer: UHC Exchange |
$402.99
|
| Rate for Payer: UHC Medicare Advantage |
$402.99
|
| Rate for Payer: UHCCP Medicaid |
$273.71
|
|
|
PR EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5CM/>
|
Professional
|
Both
|
$1,839.00
|
|
|
Service Code
|
HCPCS 26113
|
| Min. Negotiated Rate |
$254.28 |
| Max. Negotiated Rate |
$1,195.35 |
| Rate for Payer: Aetna Commercial |
$710.44
|
| Rate for Payer: Aetna Medicare |
$551.39
|
| Rate for Payer: BCBS Complete |
$378.19
|
| Rate for Payer: BCBS MAPPO |
$530.18
|
| Rate for Payer: BCBS Trust/PPO |
$254.28
|
| Rate for Payer: BCN Commercial |
$807.78
|
| Rate for Payer: BCN Medicare Advantage |
$530.18
|
| Rate for Payer: Cash Price |
$1,471.20
|
| Rate for Payer: Cash Price |
$1,471.20
|
| Rate for Payer: Cofinity Commercial |
$763.46
|
| Rate for Payer: Cofinity Commercial |
$710.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$530.18
|
| Rate for Payer: Mclaren Medicaid |
$360.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$556.69
|
| Rate for Payer: Meridian Medicaid |
$378.19
|
| Rate for Payer: Nomi Health Commercial |
$636.22
|
| Rate for Payer: PACE SWMI |
$530.18
|
| Rate for Payer: PHP Medicare Advantage |
$530.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$360.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,195.35
|
| Rate for Payer: Priority Health HMO/PPO |
$850.30
|
| Rate for Payer: Priority Health Medicare |
$535.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$850.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$530.18
|
| Rate for Payer: UHC Exchange |
$530.18
|
| Rate for Payer: UHC Medicare Advantage |
$530.18
|
| Rate for Payer: UHCCP Medicaid |
$360.18
|
|
|
PR FAA PHYSICAL
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 00180
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$53.20 |
| Max. Negotiated Rate |
$86.45 |
| Rate for Payer: Aetna Medicare |
$66.50
|
| Rate for Payer: BCBS Complete |
$53.20
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.45
|
|
|
PR FACIAL NERVE FUNCTION STUDIES
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 92516
|
| Min. Negotiated Rate |
$21.24 |
| Max. Negotiated Rate |
$2,145.40 |
| Rate for Payer: Aetna Commercial |
$28.46
|
| Rate for Payer: Aetna Medicare |
$22.09
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS MAPPO |
$21.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,145.40
|
| Rate for Payer: BCN Commercial |
$103.60
|
| Rate for Payer: BCN Medicare Advantage |
$21.24
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$30.59
|
| Rate for Payer: Cofinity Commercial |
$28.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.30
|
| Rate for Payer: Nomi Health Commercial |
$25.49
|
| Rate for Payer: PACE SWMI |
$21.24
|
| Rate for Payer: PHP Medicare Advantage |
$21.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health HMO/PPO |
$30.30
|
| Rate for Payer: Priority Health Medicare |
$21.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.24
|
| Rate for Payer: UHC Exchange |
$21.24
|
| Rate for Payer: UHC Medicare Advantage |
$21.24
|
|
|
PR FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 97156
|
| Min. Negotiated Rate |
$20.79 |
| Max. Negotiated Rate |
$1,096.22 |
| Rate for Payer: Aetna Commercial |
$20.79
|
| Rate for Payer: Aetna Medicare |
$27.00
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,096.22
|
| Rate for Payer: BCN Commercial |
$37.50
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health HMO/PPO |
$47.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.04
|
|
|
PR FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS
|
Professional
|
Both
|
$161.00
|
|
|
Service Code
|
HCPCS 90846
|
| Min. Negotiated Rate |
$64.40 |
| Max. Negotiated Rate |
$346.04 |
| Rate for Payer: Aetna Commercial |
$130.86
|
| Rate for Payer: Aetna Medicare |
$101.57
|
| Rate for Payer: BCBS Complete |
$64.40
|
| Rate for Payer: BCBS MAPPO |
$97.66
|
| Rate for Payer: BCBS Trust/PPO |
$346.04
|
| Rate for Payer: BCN Commercial |
$137.81
|
| Rate for Payer: BCN Medicare Advantage |
$97.66
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$140.63
|
| Rate for Payer: Cofinity Commercial |
$130.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.54
|
| Rate for Payer: Nomi Health Commercial |
$117.19
|
| Rate for Payer: PACE SWMI |
$97.66
|
| Rate for Payer: PHP Medicare Advantage |
$97.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health HMO/PPO |
$107.43
|
| Rate for Payer: Priority Health Medicare |
$98.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.66
|
| Rate for Payer: UHC Exchange |
$97.66
|
| Rate for Payer: UHC Medicare Advantage |
$97.66
|
|
