|
PR FASCIOTOMY PALMAR OPEN PARTIAL
|
Professional
|
Both
|
$1,368.00
|
|
|
Service Code
|
HCPCS 26045
|
| Min. Negotiated Rate |
$458.19 |
| Max. Negotiated Rate |
$889.20 |
| Rate for Payer: Aetna Commercial |
$613.97
|
| Rate for Payer: Aetna Medicare |
$476.52
|
| Rate for Payer: BCBS Complete |
$547.20
|
| Rate for Payer: BCBS MAPPO |
$458.19
|
| Rate for Payer: BCN Medicare Advantage |
$458.19
|
| Rate for Payer: Cash Price |
$1,094.40
|
| Rate for Payer: Cash Price |
$1,094.40
|
| Rate for Payer: Cofinity Commercial |
$659.79
|
| Rate for Payer: Cofinity Commercial |
$613.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$458.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$481.10
|
| Rate for Payer: Nomi Health Commercial |
$549.83
|
| Rate for Payer: PACE SWMI |
$458.19
|
| Rate for Payer: PHP Medicare Advantage |
$458.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$889.20
|
| Rate for Payer: Priority Health Medicare |
$462.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$458.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$458.19
|
| Rate for Payer: UHC Exchange |
$458.19
|
| Rate for Payer: UHC Medicare Advantage |
$458.19
|
|
|
PR FASCIOTOMY PALMAR PERCUTANEOUS
|
Professional
|
Both
|
$930.00
|
|
|
Service Code
|
HCPCS 26040
|
| Min. Negotiated Rate |
$306.15 |
| Max. Negotiated Rate |
$604.50 |
| Rate for Payer: Aetna Commercial |
$410.24
|
| Rate for Payer: Aetna Medicare |
$318.40
|
| Rate for Payer: BCBS Complete |
$372.00
|
| Rate for Payer: BCBS MAPPO |
$306.15
|
| Rate for Payer: BCN Medicare Advantage |
$306.15
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cash Price |
$744.00
|
| Rate for Payer: Cofinity Commercial |
$440.86
|
| Rate for Payer: Cofinity Commercial |
$410.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.46
|
| Rate for Payer: Nomi Health Commercial |
$367.38
|
| Rate for Payer: PACE SWMI |
$306.15
|
| Rate for Payer: PHP Medicare Advantage |
$306.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.50
|
| Rate for Payer: Priority Health Medicare |
$309.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$306.15
|
| Rate for Payer: UHC Exchange |
$306.15
|
| Rate for Payer: UHC Medicare Advantage |
$306.15
|
|
|
PR FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT
|
Professional
|
Both
|
$2,361.00
|
|
|
Service Code
|
HCPCS 26121
|
| Min. Negotiated Rate |
$580.37 |
| Max. Negotiated Rate |
$1,534.65 |
| Rate for Payer: Aetna Commercial |
$777.70
|
| Rate for Payer: Aetna Medicare |
$603.58
|
| Rate for Payer: BCBS Complete |
$944.40
|
| Rate for Payer: BCBS MAPPO |
$580.37
|
| Rate for Payer: BCN Medicare Advantage |
$580.37
|
| Rate for Payer: Cash Price |
$1,888.80
|
| Rate for Payer: Cash Price |
$1,888.80
|
| Rate for Payer: Cofinity Commercial |
$835.73
|
| Rate for Payer: Cofinity Commercial |
$777.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$580.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$609.39
|
| Rate for Payer: Nomi Health Commercial |
$696.44
|
| Rate for Payer: PACE SWMI |
$580.37
|
| Rate for Payer: PHP Medicare Advantage |
$580.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,534.65
|
| Rate for Payer: Priority Health Medicare |
$586.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$580.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$580.37
|
| Rate for Payer: UHC Exchange |
$580.37
|
| Rate for Payer: UHC Medicare Advantage |
$580.37
|
|
|
PR FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR
|
Professional
|
Both
|
$2,952.00
|
|
|
Service Code
|
HCPCS 26123
|
| Min. Negotiated Rate |
$809.00 |
| Max. Negotiated Rate |
$1,918.80 |
| Rate for Payer: Aetna Commercial |
$1,084.06
|
| Rate for Payer: Aetna Medicare |
$841.36
|
| Rate for Payer: BCBS Complete |
$1,180.80
|
| Rate for Payer: BCBS MAPPO |
$809.00
|
| Rate for Payer: BCN Medicare Advantage |
$809.00
|
| Rate for Payer: Cash Price |
$2,361.60
|
| Rate for Payer: Cash Price |
$2,361.60
|
| Rate for Payer: Cofinity Commercial |
$1,164.96
|
| Rate for Payer: Cofinity Commercial |
$1,084.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$809.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$849.45
|
| Rate for Payer: Nomi Health Commercial |
$970.80
|
| Rate for Payer: PACE SWMI |
$809.00
|
| Rate for Payer: PHP Medicare Advantage |
$809.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,918.80
|
| Rate for Payer: Priority Health Medicare |
$817.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$809.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$809.00
|
| Rate for Payer: UHC Exchange |
$809.00
|
| Rate for Payer: UHC Medicare Advantage |
$809.00
|
|
|
PR FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR
|
Professional
|
Both
|
$885.00
|
|
|
Service Code
|
HCPCS 26125
|
| Min. Negotiated Rate |
$257.96 |
| Max. Negotiated Rate |
$575.25 |
| Rate for Payer: Aetna Commercial |
$345.67
|
| Rate for Payer: Aetna Medicare |
$268.28
|
| Rate for Payer: BCBS Complete |
$354.00
|
| Rate for Payer: BCBS MAPPO |
$257.96
|
| Rate for Payer: BCN Medicare Advantage |
$257.96
|
| Rate for Payer: Cash Price |
$708.00
|
| Rate for Payer: Cash Price |
$708.00
|
| Rate for Payer: Cofinity Commercial |
$371.46
|
| Rate for Payer: Cofinity Commercial |
$345.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.86
|
| Rate for Payer: Nomi Health Commercial |
$309.55
|
| Rate for Payer: PACE SWMI |
$257.96
|
| Rate for Payer: PHP Medicare Advantage |
$257.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.25
|
| Rate for Payer: Priority Health Medicare |
$260.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.96
|
| Rate for Payer: UHC Exchange |
$257.96
|
| Rate for Payer: UHC Medicare Advantage |
$257.96
|
|
|
PR FECAL BLOOD SCRN IMMUNOASSAY
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS G0328
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$25.99 |
| Rate for Payer: Aetna Commercial |
$24.19
|
| Rate for Payer: Aetna Medicare |
$18.77
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$18.05
|
| Rate for Payer: BCN Medicare Advantage |
$18.05
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cofinity Commercial |
$25.99
|
| Rate for Payer: Cofinity Commercial |
$24.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.95
|
| Rate for Payer: Nomi Health Commercial |
$21.66
|
| Rate for Payer: PACE SWMI |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
| Rate for Payer: Priority Health Medicare |
$18.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.05
|
| Rate for Payer: UHC Exchange |
$18.05
|
| Rate for Payer: UHC Medicare Advantage |
$18.05
|
|
|
PR FECAL MICROBIOTA PREP INSTIL
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS G0455
|
| Min. Negotiated Rate |
$67.10 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Aetna Commercial |
$89.91
|
| Rate for Payer: Aetna Medicare |
$69.78
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCBS MAPPO |
$67.10
|
| Rate for Payer: BCN Medicare Advantage |
$67.10
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$96.62
|
| Rate for Payer: Cofinity Commercial |
$89.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.45
|
| Rate for Payer: Nomi Health Commercial |
$80.52
|
| Rate for Payer: PACE SWMI |
$67.10
|
| Rate for Payer: PHP Medicare Advantage |
$67.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health Medicare |
$67.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.10
|
| Rate for Payer: UHC Exchange |
$67.10
|
| Rate for Payer: UHC Medicare Advantage |
$67.10
|
|
|
PR FERN TEST
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS Q0114
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$14.03 |
| Rate for Payer: Aetna Commercial |
$13.05
|
| Rate for Payer: Aetna Medicare |
$10.13
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCBS MAPPO |
$9.74
|
| Rate for Payer: BCN Medicare Advantage |
$9.74
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$14.03
|
| Rate for Payer: Cofinity Commercial |
$13.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.23
|
| Rate for Payer: Nomi Health Commercial |
$11.69
|
| Rate for Payer: PACE SWMI |
$9.74
|
| Rate for Payer: PHP Medicare Advantage |
$9.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.90
|
| Rate for Payer: Priority Health Medicare |
$9.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.74
|
| Rate for Payer: UHC Exchange |
$9.74
|
| Rate for Payer: UHC Medicare Advantage |
$9.74
|
|
|
PR FETAL CONTRACTION STRESS TEST
|
Professional
|
Both
|
$164.00
|
|
|
Service Code
|
HCPCS 59020
|
| Min. Negotiated Rate |
$65.60 |
| Max. Negotiated Rate |
$106.60 |
| Rate for Payer: Aetna Commercial |
$88.69
|
| Rate for Payer: Aetna Medicare |
$68.84
|
| Rate for Payer: BCBS Complete |
$65.60
|
| Rate for Payer: BCBS MAPPO |
$66.19
|
| Rate for Payer: BCN Medicare Advantage |
$66.19
|
| Rate for Payer: Cash Price |
$131.20
|
| Rate for Payer: Cash Price |
$131.20
|
| Rate for Payer: Cofinity Commercial |
$95.31
|
| Rate for Payer: Cofinity Commercial |
$88.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.50
|
| Rate for Payer: Nomi Health Commercial |
$79.43
|
| Rate for Payer: PACE SWMI |
$66.19
|
| Rate for Payer: PHP Medicare Advantage |
$66.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.60
|
| Rate for Payer: Priority Health Medicare |
$66.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.19
|
| Rate for Payer: UHC Exchange |
$66.19
|
| Rate for Payer: UHC Medicare Advantage |
$66.19
|
|
|
PR FETAL FLUID DRAINAGE W/ULTRASOUND GUIDANCE
|
Professional
|
Both
|
$842.00
|
|
|
Service Code
|
HCPCS 59074
|
| Min. Negotiated Rate |
$301.73 |
| Max. Negotiated Rate |
$547.30 |
| Rate for Payer: Aetna Commercial |
$404.32
|
| Rate for Payer: Aetna Medicare |
$313.80
|
| Rate for Payer: BCBS Complete |
$336.80
|
| Rate for Payer: BCBS MAPPO |
$301.73
|
| Rate for Payer: BCN Medicare Advantage |
$301.73
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cash Price |
$673.60
|
| Rate for Payer: Cofinity Commercial |
$434.49
|
| Rate for Payer: Cofinity Commercial |
$404.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.82
|
| Rate for Payer: Nomi Health Commercial |
$362.08
|
| Rate for Payer: PACE SWMI |
$301.73
|
| Rate for Payer: PHP Medicare Advantage |
$301.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$547.30
|
| Rate for Payer: Priority Health Medicare |
$304.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$301.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.73
|
| Rate for Payer: UHC Exchange |
$301.73
|
| Rate for Payer: UHC Medicare Advantage |
$301.73
|
|
|
PR FETAL NONSTRESS TEST
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 59025
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$66.70 |
| Rate for Payer: Aetna Commercial |
$62.07
|
| Rate for Payer: Aetna Medicare |
$48.17
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS MAPPO |
$46.32
|
| Rate for Payer: BCN Medicare Advantage |
$46.32
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$66.70
|
| Rate for Payer: Cofinity Commercial |
$62.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$55.58
|
| Rate for Payer: PACE SWMI |
$46.32
|
| Rate for Payer: PHP Medicare Advantage |
$46.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Medicare |
$46.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.32
|
| Rate for Payer: UHC Exchange |
$46.32
|
| Rate for Payer: UHC Medicare Advantage |
$46.32
|
|
|
PR FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE
|
Professional
|
Both
|
$1,066.00
|
|
|
Service Code
|
HCPCS 59076
|
| Min. Negotiated Rate |
$426.40 |
| Max. Negotiated Rate |
$733.52 |
| Rate for Payer: Aetna Commercial |
$682.58
|
| Rate for Payer: Aetna Medicare |
$529.77
|
| Rate for Payer: BCBS Complete |
$426.40
|
| Rate for Payer: BCBS MAPPO |
$509.39
|
| Rate for Payer: BCN Medicare Advantage |
$509.39
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Cofinity Commercial |
$733.52
|
| Rate for Payer: Cofinity Commercial |
$682.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$534.86
|
| Rate for Payer: Nomi Health Commercial |
$611.27
|
| Rate for Payer: PACE SWMI |
$509.39
|
| Rate for Payer: PHP Medicare Advantage |
$509.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.90
|
| Rate for Payer: Priority Health Medicare |
$514.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$509.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$509.39
|
| Rate for Payer: UHC Exchange |
$509.39
|
| Rate for Payer: UHC Medicare Advantage |
$509.39
|
|
|
PR FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE
|
Professional
|
Both
|
$1,293.00
|
|
|
Service Code
|
HCPCS 14350
|
| Min. Negotiated Rate |
$517.20 |
| Max. Negotiated Rate |
$912.25 |
| Rate for Payer: Aetna Commercial |
$848.90
|
| Rate for Payer: Aetna Medicare |
$658.85
|
| Rate for Payer: BCBS Complete |
$517.20
|
| Rate for Payer: BCBS MAPPO |
$633.51
|
| Rate for Payer: BCN Medicare Advantage |
$633.51
|
| Rate for Payer: Cash Price |
$1,034.40
|
| Rate for Payer: Cash Price |
$1,034.40
|
| Rate for Payer: Cofinity Commercial |
$912.25
|
| Rate for Payer: Cofinity Commercial |
$848.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$633.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$665.19
|
| Rate for Payer: Nomi Health Commercial |
$760.21
|
| Rate for Payer: PACE SWMI |
$633.51
|
| Rate for Payer: PHP Medicare Advantage |
$633.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$840.45
|
| Rate for Payer: Priority Health Medicare |
$639.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$633.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$633.51
|
| Rate for Payer: UHC Exchange |
$633.51
|
| Rate for Payer: UHC Medicare Advantage |
$633.51
|
|
|
PR FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION
|
Professional
|
Both
|
$736.00
|
|
|
Service Code
|
HCPCS 10009
|
| Min. Negotiated Rate |
$102.96 |
| Max. Negotiated Rate |
$478.40 |
| Rate for Payer: Aetna Commercial |
$137.97
|
| Rate for Payer: Aetna Commercial |
$137.97
|
| Rate for Payer: Aetna Medicare |
$107.08
|
| Rate for Payer: Aetna Medicare |
$107.08
|
| Rate for Payer: BCBS Complete |
$294.40
|
| Rate for Payer: BCBS Complete |
$106.00
|
| Rate for Payer: BCBS MAPPO |
$102.96
|
| Rate for Payer: BCBS MAPPO |
$102.96
|
| Rate for Payer: BCN Medicare Advantage |
$102.96
|
| Rate for Payer: BCN Medicare Advantage |
$102.96
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$588.80
|
| Rate for Payer: Cofinity Commercial |
$148.26
|
| Rate for Payer: Cofinity Commercial |
$148.26
|
| Rate for Payer: Cofinity Commercial |
$137.97
|
| Rate for Payer: Cofinity Commercial |
$137.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.11
|
| Rate for Payer: Nomi Health Commercial |
$123.55
|
| Rate for Payer: Nomi Health Commercial |
$123.55
|
| Rate for Payer: PACE SWMI |
$102.96
|
| Rate for Payer: PACE SWMI |
$102.96
|
| Rate for Payer: PHP Medicare Advantage |
$102.96
|
| Rate for Payer: PHP Medicare Advantage |
$102.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$478.40
|
| Rate for Payer: Priority Health Medicare |
$103.99
|
| Rate for Payer: Priority Health Medicare |
$103.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.96
|
| Rate for Payer: UHC Exchange |
$102.96
|
| Rate for Payer: UHC Exchange |
$102.96
|
| Rate for Payer: UHC Medicare Advantage |
$102.96
|
| Rate for Payer: UHC Medicare Advantage |
$102.96
|
|
|
PR FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 10021
|
| Min. Negotiated Rate |
$52.86 |
| Max. Negotiated Rate |
$154.70 |
| Rate for Payer: Aetna Commercial |
$70.83
|
| Rate for Payer: Aetna Medicare |
$54.97
|
| Rate for Payer: BCBS Complete |
$95.20
|
| Rate for Payer: BCBS MAPPO |
$52.86
|
| Rate for Payer: BCN Medicare Advantage |
$52.86
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$76.12
|
| Rate for Payer: Cofinity Commercial |
$70.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.50
|
| Rate for Payer: Nomi Health Commercial |
$63.43
|
| Rate for Payer: PACE SWMI |
$52.86
|
| Rate for Payer: PHP Medicare Advantage |
$52.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.70
|
| Rate for Payer: Priority Health Medicare |
$53.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.86
|
| Rate for Payer: UHC Exchange |
$52.86
|
| Rate for Payer: UHC Medicare Advantage |
$52.86
|
|
|
PR FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
HCPCS 10005
|
| Min. Negotiated Rate |
$69.50 |
| Max. Negotiated Rate |
$163.80 |
| Rate for Payer: Aetna Commercial |
$93.13
|
| Rate for Payer: Aetna Medicare |
$72.28
|
| Rate for Payer: BCBS Complete |
$100.80
|
| Rate for Payer: BCBS MAPPO |
$69.50
|
| Rate for Payer: BCN Medicare Advantage |
$69.50
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$93.13
|
| Rate for Payer: Cofinity Commercial |
$100.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.97
|
| Rate for Payer: Nomi Health Commercial |
$83.40
|
| Rate for Payer: PACE SWMI |
$69.50
|
| Rate for Payer: PHP Medicare Advantage |
$69.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.80
|
| Rate for Payer: Priority Health Medicare |
$70.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.50
|
| Rate for Payer: UHC Exchange |
$69.50
|
| Rate for Payer: UHC Medicare Advantage |
$69.50
|
|
|
PR FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 10006
|
| Min. Negotiated Rate |
$47.34 |
| Max. Negotiated Rate |
$79.30 |
| Rate for Payer: Aetna Commercial |
$63.44
|
| Rate for Payer: Aetna Medicare |
$49.23
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS MAPPO |
$47.34
|
| Rate for Payer: BCN Medicare Advantage |
$47.34
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$68.17
|
| Rate for Payer: Cofinity Commercial |
$63.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.71
|
| Rate for Payer: Nomi Health Commercial |
$56.81
|
| Rate for Payer: PACE SWMI |
$47.34
|
| Rate for Payer: PHP Medicare Advantage |
$47.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health Medicare |
$47.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.34
|
| Rate for Payer: UHC Exchange |
$47.34
|
| Rate for Payer: UHC Medicare Advantage |
$47.34
|
|
|
PR FINE NEEDLE ASP;W/IMAGING GUIDANCE
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 10022
|
| Min. Negotiated Rate |
$107.60 |
| Max. Negotiated Rate |
$174.85 |
| Rate for Payer: Aetna Medicare |
$134.50
|
| Rate for Payer: BCBS Complete |
$107.60
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.85
|
|
|
PR FINGER SPLINT, STATIC
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS Q4049
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.79 |
| Rate for Payer: Aetna Commercial |
$3.52
|
| Rate for Payer: Aetna Medicare |
$2.74
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCBS MAPPO |
$2.63
|
| Rate for Payer: BCN Medicare Advantage |
$2.63
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cofinity Commercial |
$3.79
|
| Rate for Payer: Cofinity Commercial |
$3.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.76
|
| Rate for Payer: Nomi Health Commercial |
$3.16
|
| Rate for Payer: PACE SWMI |
$2.63
|
| Rate for Payer: PHP Medicare Advantage |
$2.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.25
|
| Rate for Payer: Priority Health Medicare |
$2.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.63
|
| Rate for Payer: UHC Exchange |
$2.63
|
| Rate for Payer: UHC Medicare Advantage |
$2.63
|
|
|
PR FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED
|
Professional
|
Both
|
$962.00
|
|
|
Service Code
|
HCPCS 46200
|
| Min. Negotiated Rate |
$320.70 |
| Max. Negotiated Rate |
$625.30 |
| Rate for Payer: Aetna Commercial |
$429.74
|
| Rate for Payer: Aetna Medicare |
$333.53
|
| Rate for Payer: BCBS Complete |
$384.80
|
| Rate for Payer: BCBS MAPPO |
$320.70
|
| Rate for Payer: BCN Medicare Advantage |
$320.70
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cash Price |
$769.60
|
| Rate for Payer: Cofinity Commercial |
$461.81
|
| Rate for Payer: Cofinity Commercial |
$429.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.74
|
| Rate for Payer: Nomi Health Commercial |
$384.84
|
| Rate for Payer: PACE SWMI |
$320.70
|
| Rate for Payer: PHP Medicare Advantage |
$320.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$625.30
|
| Rate for Payer: Priority Health Medicare |
$323.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$320.70
|
| Rate for Payer: UHC Exchange |
$320.70
|
| Rate for Payer: UHC Medicare Advantage |
$320.70
|
|
|
PR FIT CONTACT LENS TX OCULAR SURFACE DISEASE
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 92071
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$43.55 |
| Rate for Payer: Aetna Commercial |
$40.09
|
| Rate for Payer: Aetna Medicare |
$31.12
|
| Rate for Payer: BCBS Complete |
$26.80
|
| Rate for Payer: BCBS MAPPO |
$29.92
|
| Rate for Payer: BCN Medicare Advantage |
$29.92
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$43.08
|
| Rate for Payer: Cofinity Commercial |
$40.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.42
|
| Rate for Payer: Nomi Health Commercial |
$35.90
|
| Rate for Payer: PACE SWMI |
$29.92
|
| Rate for Payer: PHP Medicare Advantage |
$29.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health Medicare |
$30.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.92
|
| Rate for Payer: UHC Exchange |
$29.92
|
| Rate for Payer: UHC Medicare Advantage |
$29.92
|
|
|
PR FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 57160
|
| Min. Negotiated Rate |
$44.50 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Commercial |
$59.63
|
| Rate for Payer: Aetna Medicare |
$46.28
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS MAPPO |
$44.50
|
| Rate for Payer: BCN Medicare Advantage |
$44.50
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$64.08
|
| Rate for Payer: Cofinity Commercial |
$59.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.73
|
| Rate for Payer: Nomi Health Commercial |
$53.40
|
| Rate for Payer: PACE SWMI |
$44.50
|
| Rate for Payer: PHP Medicare Advantage |
$44.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health Medicare |
$44.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.50
|
| Rate for Payer: UHC Exchange |
$44.50
|
| Rate for Payer: UHC Medicare Advantage |
$44.50
|
|
|
PR FITTING CONTACT LENS FOR MGMT OF KERATOCONUS 1ST
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 92072
|
| Min. Negotiated Rate |
$86.58 |
| Max. Negotiated Rate |
$143.65 |
| Rate for Payer: Aetna Commercial |
$116.02
|
| Rate for Payer: Aetna Medicare |
$90.04
|
| Rate for Payer: BCBS Complete |
$88.40
|
| Rate for Payer: BCBS MAPPO |
$86.58
|
| Rate for Payer: BCN Medicare Advantage |
$86.58
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$124.68
|
| Rate for Payer: Cofinity Commercial |
$116.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.91
|
| Rate for Payer: Nomi Health Commercial |
$103.90
|
| Rate for Payer: PACE SWMI |
$86.58
|
| Rate for Payer: PHP Medicare Advantage |
$86.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.65
|
| Rate for Payer: Priority Health Medicare |
$87.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.58
|
| Rate for Payer: UHC Exchange |
$86.58
|
| Rate for Payer: UHC Medicare Advantage |
$86.58
|
|
|
PR FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$574.00
|
|
|
Service Code
|
HCPCS 54620
|
| Min. Negotiated Rate |
$229.60 |
| Max. Negotiated Rate |
$410.76 |
| Rate for Payer: Aetna Commercial |
$382.24
|
| Rate for Payer: Aetna Medicare |
$296.66
|
| Rate for Payer: BCBS Complete |
$229.60
|
| Rate for Payer: BCBS MAPPO |
$285.25
|
| Rate for Payer: BCN Medicare Advantage |
$285.25
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cofinity Commercial |
$410.76
|
| Rate for Payer: Cofinity Commercial |
$382.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.51
|
| Rate for Payer: Nomi Health Commercial |
$342.30
|
| Rate for Payer: PACE SWMI |
$285.25
|
| Rate for Payer: PHP Medicare Advantage |
$285.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$373.10
|
| Rate for Payer: Priority Health Medicare |
$288.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.25
|
| Rate for Payer: UHC Exchange |
$285.25
|
| Rate for Payer: UHC Medicare Advantage |
$285.25
|
|
|
PR FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY
|
Professional
|
Both
|
$1,733.00
|
|
|
Service Code
|
HCPCS 15740
|
| Min. Negotiated Rate |
$693.20 |
| Max. Negotiated Rate |
$1,154.64 |
| Rate for Payer: Aetna Commercial |
$1,074.45
|
| Rate for Payer: Aetna Medicare |
$833.90
|
| Rate for Payer: BCBS Complete |
$693.20
|
| Rate for Payer: BCBS MAPPO |
$801.83
|
| Rate for Payer: BCN Medicare Advantage |
$801.83
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cash Price |
$1,386.40
|
| Rate for Payer: Cofinity Commercial |
$1,154.64
|
| Rate for Payer: Cofinity Commercial |
$1,074.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$801.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$841.92
|
| Rate for Payer: Nomi Health Commercial |
$962.20
|
| Rate for Payer: PACE SWMI |
$801.83
|
| Rate for Payer: PHP Medicare Advantage |
$801.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,126.45
|
| Rate for Payer: Priority Health Medicare |
$809.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$801.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$801.83
|
| Rate for Payer: UHC Exchange |
$801.83
|
| Rate for Payer: UHC Medicare Advantage |
$801.83
|
|
