|
PR SBSQ NURSING FACILITY CARE SF MDM 10 MINUTES
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 99307
|
| Min. Negotiated Rate |
$34.58 |
| Max. Negotiated Rate |
$2,395.31 |
| Rate for Payer: Aetna Commercial |
$51.52
|
| Rate for Payer: Aetna Medicare |
$39.99
|
| Rate for Payer: BCBS Complete |
$36.31
|
| Rate for Payer: BCBS MAPPO |
$38.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,395.31
|
| Rate for Payer: BCN Commercial |
$57.17
|
| Rate for Payer: BCN Medicare Advantage |
$38.45
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$55.37
|
| Rate for Payer: Cofinity Commercial |
$51.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.45
|
| Rate for Payer: Mclaren Medicaid |
$34.58
|
| Rate for Payer: Meridian Medicaid |
$36.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.37
|
| Rate for Payer: PACE SWMI |
$38.45
|
| Rate for Payer: PHP Medicare Advantage |
$38.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.12
|
| Rate for Payer: Priority Health Medicare |
$38.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.45
|
| Rate for Payer: UHC Medicare Advantage |
$39.60
|
|
|
PR SBSQ OBSERVATION CARE/DAY 15 MINUTES
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
HCPCS 99224
|
| Min. Negotiated Rate |
$33.20 |
| Max. Negotiated Rate |
$58.10 |
| Rate for Payer: BCBS Complete |
$33.20
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.10
|
|
|
PR SBSQ OBSERVATION CARE/DAY 25 MINUTES
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 99225
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$102.90 |
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.90
|
|
|
PR SBSQ OBSERVATION CARE/DAY 35 MINUTES
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 99226
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$154.00 |
| Rate for Payer: BCBS Complete |
$88.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
|
|
PR SBSQ PSYCHIATRIC COLLAB CARE MGMT 1ST 60 MINS
|
Professional
|
Both
|
$247.00
|
|
|
Service Code
|
HCPCS 99493
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$687.85 |
| Rate for Payer: Aetna Commercial |
$132.87
|
| Rate for Payer: Aetna Medicare |
$103.13
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$99.16
|
| Rate for Payer: BCBS Trust/PPO |
$687.85
|
| Rate for Payer: BCN Commercial |
$154.35
|
| Rate for Payer: BCN Medicare Advantage |
$99.16
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cofinity Commercial |
$132.87
|
| Rate for Payer: Cofinity Commercial |
$142.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.16
|
| Rate for Payer: Mclaren Medicaid |
$64.97
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$104.12
|
| Rate for Payer: PACE SWMI |
$99.16
|
| Rate for Payer: PHP Medicare Advantage |
$99.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.29
|
| Rate for Payer: Priority Health Medicare |
$99.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.16
|
| Rate for Payer: UHC Medicare Advantage |
$102.13
|
|
|
PR SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID
|
Professional
|
Both
|
$2,223.00
|
|
|
Service Code
|
HCPCS 49185
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$1,875.55 |
| Rate for Payer: Aetna Commercial |
$155.33
|
| Rate for Payer: Aetna Medicare |
$120.56
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS MAPPO |
$115.92
|
| Rate for Payer: BCBS Trust/PPO |
$585.36
|
| Rate for Payer: BCN Commercial |
$1,875.55
|
| Rate for Payer: BCN Medicare Advantage |
$115.92
|
| Rate for Payer: Cash Price |
$1,778.40
|
| Rate for Payer: Cash Price |
$1,778.40
|
| Rate for Payer: Cofinity Commercial |
$155.33
|
| Rate for Payer: Cofinity Commercial |
$166.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.92
|
| Rate for Payer: Mclaren Medicaid |
$74.34
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$121.72
|
| Rate for Payer: PACE SWMI |
$115.92
|
| Rate for Payer: PHP Medicare Advantage |
$115.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,556.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.62
|
| Rate for Payer: Priority Health Medicare |
$115.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.92
|
| Rate for Payer: UHC Medicare Advantage |
$119.40
|
|
|
PR SCREENING PAP SMEAR BY PHYS
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS P3001
|
| Min. Negotiated Rate |
$21.83 |
| Max. Negotiated Rate |
$2,624.07 |
| Rate for Payer: Aetna Commercial |
$29.25
|
| Rate for Payer: Aetna Medicare |
$22.70
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCBS MAPPO |
$21.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,624.07
|
| Rate for Payer: BCN Commercial |
$33.23
|
| Rate for Payer: BCN Medicare Advantage |
$21.83
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$29.25
|
| Rate for Payer: Cofinity Commercial |
$31.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.92
|
| Rate for Payer: PACE SWMI |
$21.83
|
| Rate for Payer: PHP Medicare Advantage |
$21.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.10
|
| Rate for Payer: Priority Health Medicare |
$21.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.83
|
| Rate for Payer: UHC Medicare Advantage |
$22.48
|
|
|
PR SCREENING PROCTOSCOPY
|
Professional
|
Both
|
$151.00
|
|
|
Service Code
|
HCPCS S0601
|
| Min. Negotiated Rate |
$24.45 |
| Max. Negotiated Rate |
$105.70 |
| Rate for Payer: Aetna Commercial |
$24.45
|
| Rate for Payer: BCBS Complete |
$60.40
|
| Rate for Payer: BCBS Trust/PPO |
$45.43
|
| Rate for Payer: BCN Commercial |
$67.02
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.70
|
|
|
PR SCREENING TEST PURE TONE AIR ONLY
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 92551
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$1,709.05 |
| Rate for Payer: Aetna Commercial |
$12.13
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,709.05
|
| Rate for Payer: BCN Commercial |
$17.59
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.17
|
|
|
PR SCREENING TEST VISUAL ACUITY QUANTITATIVE BILAT
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 99173
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$1,121.05 |
| Rate for Payer: Aetna Commercial |
$3.23
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,121.05
|
| Rate for Payer: BCN Commercial |
$4.39
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.04
|
|
|
PR SCR MAMMO BI INCL CAD
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
HCPCS G0202
|
| Min. Negotiated Rate |
$81.20 |
| Max. Negotiated Rate |
$142.10 |
| Rate for Payer: BCBS Complete |
$81.20
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.10
|
|
|
PR SCROTAL EXPLORATION
|
Professional
|
Both
|
$688.00
|
|
|
Service Code
|
HCPCS 55110
|
| Min. Negotiated Rate |
$249.00 |
| Max. Negotiated Rate |
$2,153.88 |
| Rate for Payer: Aetna Commercial |
$508.05
|
| Rate for Payer: Aetna Medicare |
$394.31
|
| Rate for Payer: BCBS Complete |
$261.45
|
| Rate for Payer: BCBS MAPPO |
$379.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,153.88
|
| Rate for Payer: BCN Commercial |
$562.96
|
| Rate for Payer: BCN Medicare Advantage |
$379.14
|
| Rate for Payer: Cash Price |
$550.40
|
| Rate for Payer: Cash Price |
$550.40
|
| Rate for Payer: Cofinity Commercial |
$508.05
|
| Rate for Payer: Cofinity Commercial |
$545.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$379.14
|
| Rate for Payer: Mclaren Medicaid |
$249.00
|
| Rate for Payer: Meridian Medicaid |
$261.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$398.10
|
| Rate for Payer: PACE SWMI |
$379.14
|
| Rate for Payer: PHP Medicare Advantage |
$379.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$481.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$622.49
|
| Rate for Payer: Priority Health Medicare |
$379.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$622.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$379.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$379.14
|
| Rate for Payer: UHC Medicare Advantage |
$390.51
|
|
|
PR SCROTOPLASTY COMPLICATED
|
Professional
|
Both
|
$1,386.00
|
|
|
Service Code
|
HCPCS 55180
|
| Min. Negotiated Rate |
$439.63 |
| Max. Negotiated Rate |
$1,956.82 |
| Rate for Payer: Aetna Commercial |
$902.18
|
| Rate for Payer: Aetna Medicare |
$700.20
|
| Rate for Payer: BCBS Complete |
$461.61
|
| Rate for Payer: BCBS MAPPO |
$673.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,956.82
|
| Rate for Payer: BCN Commercial |
$996.41
|
| Rate for Payer: BCN Medicare Advantage |
$673.27
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cofinity Commercial |
$969.51
|
| Rate for Payer: Cofinity Commercial |
$902.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$673.27
|
| Rate for Payer: Mclaren Medicaid |
$439.63
|
| Rate for Payer: Meridian Medicaid |
$461.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$706.93
|
| Rate for Payer: PACE SWMI |
$673.27
|
| Rate for Payer: PHP Medicare Advantage |
$673.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$439.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$970.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,101.79
|
| Rate for Payer: Priority Health Medicare |
$673.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,101.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$673.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$673.27
|
| Rate for Payer: UHC Medicare Advantage |
$693.47
|
|
|
PR SCROTOPLASTY SIMPLE
|
Professional
|
Both
|
$671.00
|
|
|
Service Code
|
HCPCS 55175
|
| Min. Negotiated Rate |
$234.30 |
| Max. Negotiated Rate |
$1,287.47 |
| Rate for Payer: Aetna Commercial |
$478.03
|
| Rate for Payer: Aetna Medicare |
$371.01
|
| Rate for Payer: BCBS Complete |
$246.02
|
| Rate for Payer: BCBS MAPPO |
$356.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,287.47
|
| Rate for Payer: BCN Commercial |
$530.22
|
| Rate for Payer: BCN Medicare Advantage |
$356.74
|
| Rate for Payer: Cash Price |
$536.80
|
| Rate for Payer: Cash Price |
$536.80
|
| Rate for Payer: Cofinity Commercial |
$513.71
|
| Rate for Payer: Cofinity Commercial |
$478.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$356.74
|
| Rate for Payer: Mclaren Medicaid |
$234.30
|
| Rate for Payer: Meridian Medicaid |
$246.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$374.58
|
| Rate for Payer: PACE SWMI |
$356.74
|
| Rate for Payer: PHP Medicare Advantage |
$356.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$234.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$586.29
|
| Rate for Payer: Priority Health Medicare |
$356.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$586.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$356.74
|
| Rate for Payer: UHC Medicare Advantage |
$367.44
|
|
|
PR SEC ABDOMINAL WALL SUTURE EVISCERATION/DEHSN
|
Professional
|
Both
|
$2,300.00
|
|
|
Service Code
|
HCPCS 49900
|
| Min. Negotiated Rate |
$529.31 |
| Max. Negotiated Rate |
$4,854.55 |
| Rate for Payer: Aetna Commercial |
$1,087.99
|
| Rate for Payer: Aetna Medicare |
$844.41
|
| Rate for Payer: BCBS Complete |
$555.78
|
| Rate for Payer: BCBS MAPPO |
$811.93
|
| Rate for Payer: BCBS Trust/PPO |
$4,854.55
|
| Rate for Payer: BCN Commercial |
$1,200.68
|
| Rate for Payer: BCN Medicare Advantage |
$811.93
|
| Rate for Payer: Cash Price |
$1,840.00
|
| Rate for Payer: Cash Price |
$1,840.00
|
| Rate for Payer: Cofinity Commercial |
$1,087.99
|
| Rate for Payer: Cofinity Commercial |
$1,169.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$811.93
|
| Rate for Payer: Mclaren Medicaid |
$529.31
|
| Rate for Payer: Meridian Medicaid |
$555.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$852.53
|
| Rate for Payer: PACE SWMI |
$811.93
|
| Rate for Payer: PHP Medicare Advantage |
$811.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$529.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,610.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,444.65
|
| Rate for Payer: Priority Health Medicare |
$811.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,444.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$811.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$811.93
|
| Rate for Payer: UHC Medicare Advantage |
$836.29
|
|
|
PR SECONDARY CLOSURE SURG WOUND/DEHSN EXTSV/COMPLIC
|
Professional
|
Both
|
$1,757.00
|
|
|
Service Code
|
HCPCS 13160
|
| Min. Negotiated Rate |
$349.63 |
| Max. Negotiated Rate |
$1,229.90 |
| Rate for Payer: Aetna Commercial |
$1,046.50
|
| Rate for Payer: Aetna Medicare |
$812.21
|
| Rate for Payer: BCBS Complete |
$534.30
|
| Rate for Payer: BCBS MAPPO |
$780.97
|
| Rate for Payer: BCBS Trust/PPO |
$349.63
|
| Rate for Payer: BCN Commercial |
$1,160.61
|
| Rate for Payer: BCN Medicare Advantage |
$780.97
|
| Rate for Payer: Cash Price |
$1,405.60
|
| Rate for Payer: Cash Price |
$1,405.60
|
| Rate for Payer: Cofinity Commercial |
$1,046.50
|
| Rate for Payer: Cofinity Commercial |
$1,124.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$780.97
|
| Rate for Payer: Mclaren Medicaid |
$508.86
|
| Rate for Payer: Meridian Medicaid |
$534.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$820.02
|
| Rate for Payer: PACE SWMI |
$780.97
|
| Rate for Payer: PHP Medicare Advantage |
$780.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,229.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$976.22
|
| Rate for Payer: Priority Health Medicare |
$780.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$976.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$780.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$780.97
|
| Rate for Payer: UHC Medicare Advantage |
$804.40
|
|
|
PR SECONDARY REVISION ORBITOCRANIOFACIAL RCNSTJ
|
Professional
|
Both
|
$4,480.00
|
|
|
Service Code
|
HCPCS 21275
|
| Min. Negotiated Rate |
$540.38 |
| Max. Negotiated Rate |
$3,205.12 |
| Rate for Payer: Aetna Commercial |
$1,109.02
|
| Rate for Payer: Aetna Medicare |
$860.74
|
| Rate for Payer: BCBS Complete |
$567.40
|
| Rate for Payer: BCBS MAPPO |
$827.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,205.12
|
| Rate for Payer: BCN Commercial |
$1,235.37
|
| Rate for Payer: BCN Medicare Advantage |
$827.63
|
| Rate for Payer: Cash Price |
$3,584.00
|
| Rate for Payer: Cash Price |
$3,584.00
|
| Rate for Payer: Cofinity Commercial |
$1,191.79
|
| Rate for Payer: Cofinity Commercial |
$1,109.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$827.63
|
| Rate for Payer: Mclaren Medicaid |
$540.38
|
| Rate for Payer: Meridian Medicaid |
$567.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$869.01
|
| Rate for Payer: PACE SWMI |
$827.63
|
| Rate for Payer: PHP Medicare Advantage |
$827.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$540.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,136.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,290.93
|
| Rate for Payer: Priority Health Medicare |
$827.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,290.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$827.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$827.63
|
| Rate for Payer: UHC Medicare Advantage |
$852.46
|
|
|
PR SECONDARY RPR DURA CSF LEAK FREE TISSUE GRAFT
|
Professional
|
Both
|
$6,167.00
|
|
|
Service Code
|
HCPCS 61618
|
| Min. Negotiated Rate |
$44.38 |
| Max. Negotiated Rate |
$4,316.90 |
| Rate for Payer: Aetna Commercial |
$1,729.69
|
| Rate for Payer: Aetna Medicare |
$1,342.44
|
| Rate for Payer: BCBS Complete |
$873.80
|
| Rate for Payer: BCBS MAPPO |
$1,290.81
|
| Rate for Payer: BCBS Trust/PPO |
$44.38
|
| Rate for Payer: BCN Commercial |
$2,635.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,290.81
|
| Rate for Payer: Cash Price |
$4,933.60
|
| Rate for Payer: Cash Price |
$4,933.60
|
| Rate for Payer: Cofinity Commercial |
$1,858.77
|
| Rate for Payer: Cofinity Commercial |
$1,729.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,290.81
|
| Rate for Payer: Mclaren Medicaid |
$832.19
|
| Rate for Payer: Meridian Medicaid |
$873.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,355.35
|
| Rate for Payer: PACE SWMI |
$1,290.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,290.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$832.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,316.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,201.47
|
| Rate for Payer: Priority Health Medicare |
$1,290.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,201.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,290.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,290.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,329.53
|
|
|
PR SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL
|
Professional
|
Both
|
$2,516.84
|
|
|
Service Code
|
HCPCS 37186
|
| Min. Negotiated Rate |
$151.23 |
| Max. Negotiated Rate |
$1,761.79 |
| Rate for Payer: Aetna Commercial |
$319.55
|
| Rate for Payer: Aetna Medicare |
$248.01
|
| Rate for Payer: BCBS Complete |
$158.79
|
| Rate for Payer: BCBS MAPPO |
$238.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.73
|
| Rate for Payer: BCN Commercial |
$1,745.07
|
| Rate for Payer: BCN Medicare Advantage |
$238.47
|
| Rate for Payer: Cash Price |
$2,013.47
|
| Rate for Payer: Cash Price |
$2,013.47
|
| Rate for Payer: Cofinity Commercial |
$319.55
|
| Rate for Payer: Cofinity Commercial |
$343.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.47
|
| Rate for Payer: Mclaren Medicaid |
$151.23
|
| Rate for Payer: Meridian Medicaid |
$158.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$250.39
|
| Rate for Payer: PACE SWMI |
$238.47
|
| Rate for Payer: PHP Medicare Advantage |
$238.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$151.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,761.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$376.09
|
| Rate for Payer: Priority Health Medicare |
$238.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$376.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.47
|
| Rate for Payer: UHC Medicare Advantage |
$245.62
|
|
|
PR SEC RPR DURA CSF LEAK LOCAL/REGIONALIZED FLAP
|
Professional
|
Both
|
$9,744.00
|
|
|
Service Code
|
HCPCS 61619
|
| Min. Negotiated Rate |
$18.49 |
| Max. Negotiated Rate |
$6,820.80 |
| Rate for Payer: Aetna Commercial |
$1,913.18
|
| Rate for Payer: Aetna Medicare |
$1,484.86
|
| Rate for Payer: BCBS Complete |
$969.30
|
| Rate for Payer: BCBS MAPPO |
$1,427.75
|
| Rate for Payer: BCBS Trust/PPO |
$18.49
|
| Rate for Payer: BCN Commercial |
$2,915.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,427.75
|
| Rate for Payer: Cash Price |
$7,795.20
|
| Rate for Payer: Cash Price |
$7,795.20
|
| Rate for Payer: Cofinity Commercial |
$2,055.96
|
| Rate for Payer: Cofinity Commercial |
$1,913.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,427.75
|
| Rate for Payer: Mclaren Medicaid |
$923.14
|
| Rate for Payer: Meridian Medicaid |
$969.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,499.14
|
| Rate for Payer: PACE SWMI |
$1,427.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,427.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$923.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,820.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,435.33
|
| Rate for Payer: Priority Health Medicare |
$1,427.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,435.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,427.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,427.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,470.58
|
|
|
PR SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 97535
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$88.75 |
| Rate for Payer: Aetna Commercial |
$42.44
|
| Rate for Payer: Aetna Medicare |
$32.94
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: BCBS MAPPO |
$31.67
|
| Rate for Payer: BCBS Trust/PPO |
$88.75
|
| Rate for Payer: BCN Commercial |
$31.97
|
| Rate for Payer: BCN Medicare Advantage |
$31.67
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$42.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.25
|
| Rate for Payer: PACE SWMI |
$31.67
|
| Rate for Payer: PHP Medicare Advantage |
$31.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.00
|
| Rate for Payer: Priority Health Medicare |
$31.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.67
|
| Rate for Payer: UHC Medicare Advantage |
$32.62
|
|
|
PR SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 92060
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$970.49 |
| Rate for Payer: Aetna Commercial |
$80.71
|
| Rate for Payer: Aetna Medicare |
$62.64
|
| Rate for Payer: BCBS Complete |
$40.00
|
| Rate for Payer: BCBS MAPPO |
$60.23
|
| Rate for Payer: BCBS Trust/PPO |
$970.49
|
| Rate for Payer: BCN Commercial |
$91.87
|
| Rate for Payer: BCN Medicare Advantage |
$60.23
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$80.71
|
| Rate for Payer: Cofinity Commercial |
$86.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$63.24
|
| Rate for Payer: PACE SWMI |
$60.23
|
| Rate for Payer: PHP Medicare Advantage |
$60.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.48
|
| Rate for Payer: Priority Health Medicare |
$60.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.23
|
| Rate for Payer: UHC Medicare Advantage |
$62.04
|
|
|
PR SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF
|
Professional
|
Both
|
$1,784.00
|
|
|
Service Code
|
HCPCS 30520
|
| Min. Negotiated Rate |
$435.16 |
| Max. Negotiated Rate |
$1,248.80 |
| Rate for Payer: Aetna Commercial |
$882.20
|
| Rate for Payer: Aetna Commercial |
$882.20
|
| Rate for Payer: Aetna Medicare |
$684.69
|
| Rate for Payer: Aetna Medicare |
$684.69
|
| Rate for Payer: BCBS Complete |
$456.92
|
| Rate for Payer: BCBS Complete |
$456.92
|
| Rate for Payer: BCBS MAPPO |
$658.36
|
| Rate for Payer: BCBS MAPPO |
$658.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,206.64
|
| Rate for Payer: BCN Commercial |
$999.83
|
| Rate for Payer: BCN Commercial |
$999.83
|
| Rate for Payer: BCN Medicare Advantage |
$658.36
|
| Rate for Payer: BCN Medicare Advantage |
$658.36
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Cash Price |
$1,427.20
|
| Rate for Payer: Cash Price |
$1,427.20
|
| Rate for Payer: Cash Price |
$2,480.00
|
| Rate for Payer: Cofinity Commercial |
$948.04
|
| Rate for Payer: Cofinity Commercial |
$882.20
|
| Rate for Payer: Cofinity Commercial |
$948.04
|
| Rate for Payer: Cofinity Commercial |
$882.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.36
|
| Rate for Payer: Mclaren Medicaid |
$435.16
|
| Rate for Payer: Mclaren Medicaid |
$435.16
|
| Rate for Payer: Meridian Medicaid |
$456.92
|
| Rate for Payer: Meridian Medicaid |
$456.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$691.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$691.28
|
| Rate for Payer: PACE SWMI |
$658.36
|
| Rate for Payer: PACE SWMI |
$658.36
|
| Rate for Payer: PHP Medicare Advantage |
$658.36
|
| Rate for Payer: PHP Medicare Advantage |
$658.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$435.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,170.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,248.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$947.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$947.39
|
| Rate for Payer: Priority Health Medicare |
$658.36
|
| Rate for Payer: Priority Health Medicare |
$658.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$947.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$947.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$658.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$658.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$658.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$658.36
|
| Rate for Payer: UHC Medicare Advantage |
$678.11
|
| Rate for Payer: UHC Medicare Advantage |
$678.11
|
|
|
PR SEQUESTRECTOMY FOREARM &/WRIST
|
Professional
|
Both
|
$2,213.00
|
|
|
Service Code
|
HCPCS 25145
|
| Min. Negotiated Rate |
$334.94 |
| Max. Negotiated Rate |
$1,549.10 |
| Rate for Payer: Aetna Commercial |
$690.26
|
| Rate for Payer: Aetna Medicare |
$535.72
|
| Rate for Payer: BCBS Complete |
$357.62
|
| Rate for Payer: BCBS MAPPO |
$515.12
|
| Rate for Payer: BCBS Trust/PPO |
$334.94
|
| Rate for Payer: BCN Commercial |
$772.60
|
| Rate for Payer: BCN Medicare Advantage |
$515.12
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cash Price |
$1,770.40
|
| Rate for Payer: Cofinity Commercial |
$741.77
|
| Rate for Payer: Cofinity Commercial |
$690.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$515.12
|
| Rate for Payer: Mclaren Medicaid |
$340.59
|
| Rate for Payer: Meridian Medicaid |
$357.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$540.88
|
| Rate for Payer: PACE SWMI |
$515.12
|
| Rate for Payer: PHP Medicare Advantage |
$515.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$340.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,549.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$807.34
|
| Rate for Payer: Priority Health Medicare |
$515.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$807.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$515.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$515.12
|
| Rate for Payer: UHC Medicare Advantage |
$530.57
|
|
|
PR SEQUESTRECTOMY SHAFT/DISTAL HUMERUS
|
Professional
|
Both
|
$2,176.00
|
|
|
Service Code
|
HCPCS 24134
|
| Min. Negotiated Rate |
$175.92 |
| Max. Negotiated Rate |
$1,523.20 |
| Rate for Payer: Aetna Commercial |
$989.50
|
| Rate for Payer: Aetna Medicare |
$767.97
|
| Rate for Payer: BCBS Complete |
$508.81
|
| Rate for Payer: BCBS MAPPO |
$738.43
|
| Rate for Payer: BCBS Trust/PPO |
$175.92
|
| Rate for Payer: BCN Commercial |
$1,101.97
|
| Rate for Payer: BCN Medicare Advantage |
$738.43
|
| Rate for Payer: Cash Price |
$1,740.80
|
| Rate for Payer: Cash Price |
$1,740.80
|
| Rate for Payer: Cofinity Commercial |
$1,063.34
|
| Rate for Payer: Cofinity Commercial |
$989.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$738.43
|
| Rate for Payer: Mclaren Medicaid |
$484.58
|
| Rate for Payer: Meridian Medicaid |
$508.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$775.35
|
| Rate for Payer: PACE SWMI |
$738.43
|
| Rate for Payer: PHP Medicare Advantage |
$738.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,523.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,151.52
|
| Rate for Payer: Priority Health Medicare |
$738.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,151.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$738.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$738.43
|
| Rate for Payer: UHC Medicare Advantage |
$760.58
|
|
