|
PR STAGING CELIOTOMY,HODGKIN'S DIS/LYMPHOMA
|
Professional
|
Both
|
$1,709.00
|
|
|
Service Code
|
HCPCS 49220
|
| Min. Negotiated Rate |
$683.60 |
| Max. Negotiated Rate |
$1,196.30 |
| Rate for Payer: BCBS Complete |
$683.60
|
| Rate for Payer: Cash Price |
$1,367.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,196.30
|
|
|
PR STANDARDIZED COGNITIVE PERFORMANCE TESTING
|
Professional
|
Both
|
$183.00
|
|
|
Service Code
|
HCPCS 96125
|
| Min. Negotiated Rate |
$73.20 |
| Max. Negotiated Rate |
$667.24 |
| Rate for Payer: Aetna Commercial |
$133.49
|
| Rate for Payer: Aetna Medicare |
$103.60
|
| Rate for Payer: BCBS Complete |
$73.20
|
| Rate for Payer: BCBS MAPPO |
$99.62
|
| Rate for Payer: BCBS Trust/PPO |
$667.24
|
| Rate for Payer: BCN Commercial |
$149.05
|
| Rate for Payer: BCN Medicare Advantage |
$99.62
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Cofinity Commercial |
$133.49
|
| Rate for Payer: Cofinity Commercial |
$143.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$104.60
|
| Rate for Payer: PACE SWMI |
$99.62
|
| Rate for Payer: PHP Medicare Advantage |
$99.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.99
|
| Rate for Payer: Priority Health Medicare |
$99.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.62
|
| Rate for Payer: UHC Medicare Advantage |
$102.61
|
|
|
PR STAPEDECTOMY/STAPEDOTOMY
|
Professional
|
Both
|
$1,668.00
|
|
|
Service Code
|
HCPCS 69660
|
| Min. Negotiated Rate |
$593.84 |
| Max. Negotiated Rate |
$1,545.81 |
| Rate for Payer: Aetna Commercial |
$1,217.87
|
| Rate for Payer: Aetna Medicare |
$945.21
|
| Rate for Payer: BCBS Complete |
$623.53
|
| Rate for Payer: BCBS MAPPO |
$908.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,545.81
|
| Rate for Payer: BCN Commercial |
$1,365.86
|
| Rate for Payer: BCN Medicare Advantage |
$908.86
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cash Price |
$1,334.40
|
| Rate for Payer: Cofinity Commercial |
$1,308.76
|
| Rate for Payer: Cofinity Commercial |
$1,217.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$908.86
|
| Rate for Payer: Mclaren Medicaid |
$593.84
|
| Rate for Payer: Meridian Medicaid |
$623.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$954.30
|
| Rate for Payer: PACE SWMI |
$908.86
|
| Rate for Payer: PHP Medicare Advantage |
$908.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$593.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,317.73
|
| Rate for Payer: Priority Health Medicare |
$908.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,317.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$908.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$908.86
|
| Rate for Payer: UHC Medicare Advantage |
$936.13
|
|
|
PR STAPEDECTOMY/STAPEDOTOMY W/FOOTPLATE DRILL OUT
|
Professional
|
Both
|
$2,385.00
|
|
|
Service Code
|
HCPCS 69661
|
| Min. Negotiated Rate |
$773.40 |
| Max. Negotiated Rate |
$1,935.16 |
| Rate for Payer: Aetna Commercial |
$1,587.20
|
| Rate for Payer: Aetna Medicare |
$1,231.86
|
| Rate for Payer: BCBS Complete |
$812.07
|
| Rate for Payer: BCBS MAPPO |
$1,184.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,935.16
|
| Rate for Payer: BCN Commercial |
$1,778.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,184.48
|
| Rate for Payer: Cash Price |
$1,908.00
|
| Rate for Payer: Cash Price |
$1,908.00
|
| Rate for Payer: Cofinity Commercial |
$1,587.20
|
| Rate for Payer: Cofinity Commercial |
$1,705.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,184.48
|
| Rate for Payer: Mclaren Medicaid |
$773.40
|
| Rate for Payer: Meridian Medicaid |
$812.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,243.70
|
| Rate for Payer: PACE SWMI |
$1,184.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,184.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$773.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,669.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,716.11
|
| Rate for Payer: Priority Health Medicare |
$1,184.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,716.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,184.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,184.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,220.01
|
|
|
PR STAPES MOBILIZATION
|
Professional
|
Both
|
$1,425.00
|
|
|
Service Code
|
HCPCS 69650
|
| Min. Negotiated Rate |
$516.95 |
| Max. Negotiated Rate |
$1,315.47 |
| Rate for Payer: Aetna Commercial |
$1,054.75
|
| Rate for Payer: Aetna Medicare |
$818.62
|
| Rate for Payer: BCBS Complete |
$542.80
|
| Rate for Payer: BCBS MAPPO |
$787.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,315.47
|
| Rate for Payer: BCN Commercial |
$1,187.00
|
| Rate for Payer: BCN Medicare Advantage |
$787.13
|
| Rate for Payer: Cash Price |
$1,140.00
|
| Rate for Payer: Cash Price |
$1,140.00
|
| Rate for Payer: Cofinity Commercial |
$1,133.47
|
| Rate for Payer: Cofinity Commercial |
$1,054.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$787.13
|
| Rate for Payer: Mclaren Medicaid |
$516.95
|
| Rate for Payer: Meridian Medicaid |
$542.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$826.49
|
| Rate for Payer: PACE SWMI |
$787.13
|
| Rate for Payer: PHP Medicare Advantage |
$787.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$516.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$997.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,145.17
|
| Rate for Payer: Priority Health Medicare |
$787.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,145.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$787.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$787.13
|
| Rate for Payer: UHC Medicare Advantage |
$810.74
|
|
|
PR STENGER TEST PURE TONE
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 92565
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$1,644.60 |
| Rate for Payer: Aetna Commercial |
$24.90
|
| Rate for Payer: Aetna Medicare |
$19.32
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$18.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,644.60
|
| Rate for Payer: BCN Commercial |
$29.32
|
| Rate for Payer: BCN Medicare Advantage |
$18.58
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$26.76
|
| Rate for Payer: Cofinity Commercial |
$24.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.51
|
| Rate for Payer: PACE SWMI |
$18.58
|
| Rate for Payer: PHP Medicare Advantage |
$18.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.95
|
| Rate for Payer: Priority Health Medicare |
$18.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.58
|
| Rate for Payer: UHC Medicare Advantage |
$19.14
|
|
|
PR STENGER TEST SPEECH
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 92577
|
| Min. Negotiated Rate |
$18.89 |
| Max. Negotiated Rate |
$2,026.03 |
| Rate for Payer: Aetna Commercial |
$25.31
|
| Rate for Payer: Aetna Medicare |
$19.65
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: BCBS MAPPO |
$18.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,026.03
|
| Rate for Payer: BCN Commercial |
$29.81
|
| Rate for Payer: BCN Medicare Advantage |
$18.89
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$25.31
|
| Rate for Payer: Cofinity Commercial |
$27.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.83
|
| Rate for Payer: PACE SWMI |
$18.89
|
| Rate for Payer: PHP Medicare Advantage |
$18.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.40
|
| Rate for Payer: Priority Health Medicare |
$18.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.89
|
| Rate for Payer: UHC Medicare Advantage |
$19.46
|
|
|
PR STENT PLMT CENTRAL DIAYLSIS SEG PFRMD DIAL CIR
|
Professional
|
Both
|
$565.00
|
|
|
Service Code
|
HCPCS 36908
|
| Min. Negotiated Rate |
$128.44 |
| Max. Negotiated Rate |
$2,085.19 |
| Rate for Payer: Aetna Commercial |
$270.81
|
| Rate for Payer: Aetna Medicare |
$210.18
|
| Rate for Payer: BCBS Complete |
$134.86
|
| Rate for Payer: BCBS MAPPO |
$202.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,924.07
|
| Rate for Payer: BCN Commercial |
$2,085.19
|
| Rate for Payer: BCN Medicare Advantage |
$202.10
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cofinity Commercial |
$291.02
|
| Rate for Payer: Cofinity Commercial |
$270.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$202.10
|
| Rate for Payer: Mclaren Medicaid |
$128.44
|
| Rate for Payer: Meridian Medicaid |
$134.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$212.20
|
| Rate for Payer: PACE SWMI |
$202.10
|
| Rate for Payer: PHP Medicare Advantage |
$202.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$395.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$319.70
|
| Rate for Payer: Priority Health Medicare |
$202.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$319.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$202.10
|
| Rate for Payer: UHC Medicare Advantage |
$208.16
|
|
|
PR STEREOSCOPIC X-RAY GUIDANCE
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS G6002
|
| Min. Negotiated Rate |
$12.99 |
| Max. Negotiated Rate |
$590.64 |
| Rate for Payer: Aetna Commercial |
$94.05
|
| Rate for Payer: Aetna Commercial |
$94.05
|
| Rate for Payer: Aetna Medicare |
$73.00
|
| Rate for Payer: Aetna Medicare |
$73.00
|
| Rate for Payer: BCBS Complete |
$13.64
|
| Rate for Payer: BCBS Complete |
$13.64
|
| Rate for Payer: BCBS MAPPO |
$70.19
|
| Rate for Payer: BCBS MAPPO |
$70.19
|
| Rate for Payer: BCBS Trust/PPO |
$590.64
|
| Rate for Payer: BCBS Trust/PPO |
$590.64
|
| Rate for Payer: BCN Commercial |
$108.97
|
| Rate for Payer: BCN Commercial |
$108.97
|
| Rate for Payer: BCN Medicare Advantage |
$70.19
|
| Rate for Payer: BCN Medicare Advantage |
$70.19
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$94.05
|
| Rate for Payer: Cofinity Commercial |
$94.05
|
| Rate for Payer: Cofinity Commercial |
$101.07
|
| Rate for Payer: Cofinity Commercial |
$101.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.19
|
| Rate for Payer: Mclaren Medicaid |
$12.99
|
| Rate for Payer: Mclaren Medicaid |
$12.99
|
| Rate for Payer: Meridian Medicaid |
$13.64
|
| Rate for Payer: Meridian Medicaid |
$13.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$73.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$73.70
|
| Rate for Payer: PACE SWMI |
$70.19
|
| Rate for Payer: PACE SWMI |
$70.19
|
| Rate for Payer: PHP Medicare Advantage |
$70.19
|
| Rate for Payer: PHP Medicare Advantage |
$70.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.22
|
| Rate for Payer: Priority Health Medicare |
$70.19
|
| Rate for Payer: Priority Health Medicare |
$70.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.19
|
| Rate for Payer: UHC Medicare Advantage |
$72.30
|
| Rate for Payer: UHC Medicare Advantage |
$72.30
|
|
|
PR STEREOTACTIC BX ASPIR/EXC BURR INTRACRANIAL LES
|
Professional
|
Both
|
$2,917.88
|
|
|
Service Code
|
HCPCS 61750
|
| Min. Negotiated Rate |
$662.49 |
| Max. Negotiated Rate |
$2,885.28 |
| Rate for Payer: Aetna Commercial |
$1,900.37
|
| Rate for Payer: Aetna Medicare |
$1,474.92
|
| Rate for Payer: BCBS Complete |
$960.80
|
| Rate for Payer: BCBS MAPPO |
$1,418.19
|
| Rate for Payer: BCBS Trust/PPO |
$662.49
|
| Rate for Payer: BCN Commercial |
$2,885.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,418.19
|
| Rate for Payer: Cash Price |
$2,334.30
|
| Rate for Payer: Cash Price |
$2,334.30
|
| Rate for Payer: Cofinity Commercial |
$1,900.37
|
| Rate for Payer: Cofinity Commercial |
$2,042.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,418.19
|
| Rate for Payer: Mclaren Medicaid |
$915.05
|
| Rate for Payer: Meridian Medicaid |
$960.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,489.10
|
| Rate for Payer: PACE SWMI |
$1,418.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,418.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$915.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,042.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,409.85
|
| Rate for Payer: Priority Health Medicare |
$1,418.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,409.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,418.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,418.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,460.74
|
|
|
PR STEREOTACTIC COMPUTER ASSISTED PX SPINAL
|
Professional
|
Both
|
$728.00
|
|
|
Service Code
|
HCPCS 61783
|
| Min. Negotiated Rate |
$147.61 |
| Max. Negotiated Rate |
$707.92 |
| Rate for Payer: Aetna Commercial |
$310.89
|
| Rate for Payer: Aetna Medicare |
$241.29
|
| Rate for Payer: BCBS Complete |
$154.99
|
| Rate for Payer: BCBS MAPPO |
$232.01
|
| Rate for Payer: BCBS Trust/PPO |
$707.92
|
| Rate for Payer: BCN Commercial |
$337.68
|
| Rate for Payer: BCN Medicare Advantage |
$232.01
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cofinity Commercial |
$334.09
|
| Rate for Payer: Cofinity Commercial |
$310.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.01
|
| Rate for Payer: Mclaren Medicaid |
$147.61
|
| Rate for Payer: Meridian Medicaid |
$154.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$243.61
|
| Rate for Payer: PACE SWMI |
$232.01
|
| Rate for Payer: PHP Medicare Advantage |
$232.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$391.26
|
| Rate for Payer: Priority Health Medicare |
$232.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$391.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$232.01
|
| Rate for Payer: UHC Medicare Advantage |
$238.97
|
|
|
PR STEREOTACTIC RADIOSURGERY 1 COMPLEX CRANIAL LES
|
Professional
|
Both
|
$8,153.00
|
|
|
Service Code
|
HCPCS 61798
|
| Min. Negotiated Rate |
$896.73 |
| Max. Negotiated Rate |
$5,707.10 |
| Rate for Payer: Aetna Commercial |
$1,863.00
|
| Rate for Payer: Aetna Medicare |
$1,445.91
|
| Rate for Payer: BCBS Complete |
$941.57
|
| Rate for Payer: BCBS MAPPO |
$1,390.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,623.47
|
| Rate for Payer: BCN Commercial |
$2,036.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,390.30
|
| Rate for Payer: Cash Price |
$6,522.40
|
| Rate for Payer: Cash Price |
$6,522.40
|
| Rate for Payer: Cofinity Commercial |
$1,863.00
|
| Rate for Payer: Cofinity Commercial |
$2,002.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,390.30
|
| Rate for Payer: Mclaren Medicaid |
$896.73
|
| Rate for Payer: Meridian Medicaid |
$941.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,459.82
|
| Rate for Payer: PACE SWMI |
$1,390.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,390.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$896.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,707.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,360.02
|
| Rate for Payer: Priority Health Medicare |
$1,390.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,360.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,390.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,390.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,432.01
|
|
|
PR STEREOTACTIC RADIOSURGERY 1 SIMPLE CRANIAL LES
|
Professional
|
Both
|
$8,153.00
|
|
|
Service Code
|
HCPCS 61796
|
| Min. Negotiated Rate |
$663.50 |
| Max. Negotiated Rate |
$5,707.10 |
| Rate for Payer: Aetna Commercial |
$1,373.61
|
| Rate for Payer: Aetna Medicare |
$1,066.08
|
| Rate for Payer: BCBS Complete |
$696.68
|
| Rate for Payer: BCBS MAPPO |
$1,025.08
|
| Rate for Payer: BCBS Trust/PPO |
$828.90
|
| Rate for Payer: BCN Commercial |
$1,506.59
|
| Rate for Payer: BCN Medicare Advantage |
$1,025.08
|
| Rate for Payer: Cash Price |
$6,522.40
|
| Rate for Payer: Cash Price |
$6,522.40
|
| Rate for Payer: Cofinity Commercial |
$1,373.61
|
| Rate for Payer: Cofinity Commercial |
$1,476.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,025.08
|
| Rate for Payer: Mclaren Medicaid |
$663.50
|
| Rate for Payer: Meridian Medicaid |
$696.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,076.33
|
| Rate for Payer: PACE SWMI |
$1,025.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,025.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$663.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,707.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,745.66
|
| Rate for Payer: Priority Health Medicare |
$1,025.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,745.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,025.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,025.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,055.83
|
|
|
PR STEREOTACTIC RADIOSURGERY 1 SPINAL LESION
|
Professional
|
Both
|
$2,290.00
|
|
|
Service Code
|
HCPCS 63620
|
| Min. Negotiated Rate |
$733.15 |
| Max. Negotiated Rate |
$1,929.70 |
| Rate for Payer: Aetna Commercial |
$1,520.20
|
| Rate for Payer: Aetna Medicare |
$1,179.86
|
| Rate for Payer: BCBS Complete |
$769.81
|
| Rate for Payer: BCBS MAPPO |
$1,134.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,093.05
|
| Rate for Payer: BCN Commercial |
$1,665.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,134.48
|
| Rate for Payer: Cash Price |
$1,832.00
|
| Rate for Payer: Cash Price |
$1,832.00
|
| Rate for Payer: Cofinity Commercial |
$1,633.65
|
| Rate for Payer: Cofinity Commercial |
$1,520.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,134.48
|
| Rate for Payer: Mclaren Medicaid |
$733.15
|
| Rate for Payer: Meridian Medicaid |
$769.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,191.20
|
| Rate for Payer: PACE SWMI |
$1,134.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,134.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$733.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,603.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,929.70
|
| Rate for Payer: Priority Health Medicare |
$1,134.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,929.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,134.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,134.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,168.51
|
|
|
PR STERILE SALINE OR WATER
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS A4218
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$1.75 |
| Rate for Payer: Aetna Commercial |
$1.75
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: BCN Commercial |
$1.04
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.40
|
|
|
PR STERNAL DEBRIDEMENT
|
Professional
|
Both
|
$4,067.00
|
|
|
Service Code
|
HCPCS 21627
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$2,846.90 |
| Rate for Payer: Aetna Commercial |
$717.66
|
| Rate for Payer: Aetna Medicare |
$556.99
|
| Rate for Payer: BCBS Complete |
$369.92
|
| Rate for Payer: BCBS MAPPO |
$535.57
|
| Rate for Payer: BCBS Trust/PPO |
$35.00
|
| Rate for Payer: BCN Commercial |
$798.50
|
| Rate for Payer: BCN Medicare Advantage |
$535.57
|
| Rate for Payer: Cash Price |
$3,253.60
|
| Rate for Payer: Cash Price |
$3,253.60
|
| Rate for Payer: Cofinity Commercial |
$771.22
|
| Rate for Payer: Cofinity Commercial |
$717.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$535.57
|
| Rate for Payer: Mclaren Medicaid |
$352.30
|
| Rate for Payer: Meridian Medicaid |
$369.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$562.35
|
| Rate for Payer: PACE SWMI |
$535.57
|
| Rate for Payer: PHP Medicare Advantage |
$535.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$352.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,846.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$834.41
|
| Rate for Payer: Priority Health Medicare |
$535.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$834.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$535.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$535.57
|
| Rate for Payer: UHC Medicare Advantage |
$551.64
|
|
|
PR STOT/TOT HYSTERECTOMY AFTER CESAREAN DELIVERY
|
Professional
|
Both
|
$1,120.00
|
|
|
Service Code
|
HCPCS 59525
|
| Min. Negotiated Rate |
$106.19 |
| Max. Negotiated Rate |
$784.00 |
| Rate for Payer: Aetna Commercial |
$648.02
|
| Rate for Payer: Aetna Medicare |
$502.94
|
| Rate for Payer: BCBS Complete |
$322.95
|
| Rate for Payer: BCBS MAPPO |
$483.60
|
| Rate for Payer: BCBS Trust/PPO |
$106.19
|
| Rate for Payer: BCN Commercial |
$702.23
|
| Rate for Payer: BCN Medicare Advantage |
$483.60
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cofinity Commercial |
$648.02
|
| Rate for Payer: Cofinity Commercial |
$696.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$483.60
|
| Rate for Payer: Mclaren Medicaid |
$307.57
|
| Rate for Payer: Meridian Medicaid |
$322.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$507.78
|
| Rate for Payer: PACE SWMI |
$483.60
|
| Rate for Payer: PHP Medicare Advantage |
$483.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$307.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$784.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$678.51
|
| Rate for Payer: Priority Health Medicare |
$483.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$678.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$483.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$483.60
|
| Rate for Payer: UHC Medicare Advantage |
$498.11
|
|
|
PR STRABISMUS RECESSION/RESCJ 1 HRZNTL MUSC
|
Professional
|
Both
|
$1,417.00
|
|
|
Service Code
|
HCPCS 67311
|
| Min. Negotiated Rate |
$288.62 |
| Max. Negotiated Rate |
$991.90 |
| Rate for Payer: Aetna Commercial |
$581.17
|
| Rate for Payer: Aetna Medicare |
$451.06
|
| Rate for Payer: BCBS Complete |
$303.05
|
| Rate for Payer: BCBS MAPPO |
$433.71
|
| Rate for Payer: BCBS Trust/PPO |
$310.11
|
| Rate for Payer: BCN Commercial |
$654.34
|
| Rate for Payer: BCN Medicare Advantage |
$433.71
|
| Rate for Payer: Cash Price |
$1,133.60
|
| Rate for Payer: Cash Price |
$1,133.60
|
| Rate for Payer: Cofinity Commercial |
$581.17
|
| Rate for Payer: Cofinity Commercial |
$624.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.71
|
| Rate for Payer: Mclaren Medicaid |
$288.62
|
| Rate for Payer: Meridian Medicaid |
$303.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$455.40
|
| Rate for Payer: PACE SWMI |
$433.71
|
| Rate for Payer: PHP Medicare Advantage |
$433.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$288.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$991.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$783.88
|
| Rate for Payer: Priority Health Medicare |
$433.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$783.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$433.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$433.71
|
| Rate for Payer: UHC Medicare Advantage |
$446.72
|
|
|
PR STRAIGHT TIP URINE CATHETER
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS A4351
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$7.00 |
| Rate for Payer: Aetna Commercial |
$1.69
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCN Commercial |
$2.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.00
|
|
|
PR STRAPPING ANKLE &/FOOT
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
HCPCS 29540
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$984.22 |
| Rate for Payer: Aetna Commercial |
$23.38
|
| Rate for Payer: Aetna Medicare |
$18.15
|
| Rate for Payer: BCBS Complete |
$11.40
|
| Rate for Payer: BCBS MAPPO |
$17.45
|
| Rate for Payer: BCBS Trust/PPO |
$984.22
|
| Rate for Payer: BCN Commercial |
$32.99
|
| Rate for Payer: BCN Medicare Advantage |
$17.45
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$25.13
|
| Rate for Payer: Cofinity Commercial |
$23.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.45
|
| Rate for Payer: Mclaren Medicaid |
$10.86
|
| Rate for Payer: Meridian Medicaid |
$11.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.32
|
| Rate for Payer: PACE SWMI |
$17.45
|
| Rate for Payer: PHP Medicare Advantage |
$17.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.55
|
| Rate for Payer: Priority Health Medicare |
$17.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.45
|
| Rate for Payer: UHC Medicare Advantage |
$17.97
|
|
|
PR STRAPPING ELBOW/WRIST
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 29260
|
| Min. Negotiated Rate |
$11.93 |
| Max. Negotiated Rate |
$1,354.56 |
| Rate for Payer: Aetna Commercial |
$25.46
|
| Rate for Payer: Aetna Medicare |
$19.76
|
| Rate for Payer: BCBS Complete |
$12.53
|
| Rate for Payer: BCBS MAPPO |
$19.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,354.56
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: BCN Medicare Advantage |
$19.00
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$27.36
|
| Rate for Payer: Cofinity Commercial |
$25.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.00
|
| Rate for Payer: Mclaren Medicaid |
$11.93
|
| Rate for Payer: Meridian Medicaid |
$12.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.95
|
| Rate for Payer: PACE SWMI |
$19.00
|
| Rate for Payer: PHP Medicare Advantage |
$19.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.11
|
| Rate for Payer: Priority Health Medicare |
$19.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.00
|
| Rate for Payer: UHC Medicare Advantage |
$19.57
|
|
|
PR STRAPPING TOES
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 29550
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$958.34 |
| Rate for Payer: Aetna Commercial |
$14.81
|
| Rate for Payer: Aetna Medicare |
$11.49
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS MAPPO |
$11.05
|
| Rate for Payer: BCBS Trust/PPO |
$958.34
|
| Rate for Payer: BCN Commercial |
$22.39
|
| Rate for Payer: BCN Medicare Advantage |
$11.05
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$15.91
|
| Rate for Payer: Cofinity Commercial |
$14.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.05
|
| Rate for Payer: Mclaren Medicaid |
$7.03
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.60
|
| Rate for Payer: PACE SWMI |
$11.05
|
| Rate for Payer: PHP Medicare Advantage |
$11.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.85
|
| Rate for Payer: Priority Health Medicare |
$11.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.05
|
| Rate for Payer: UHC Medicare Advantage |
$11.38
|
|
|
PR STRAPPING UNNA BOOT
|
Professional
|
Both
|
$93.00
|
|
|
Service Code
|
HCPCS 29580
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$1,192.37 |
| Rate for Payer: Aetna Commercial |
$35.01
|
| Rate for Payer: Aetna Medicare |
$27.18
|
| Rate for Payer: BCBS Complete |
$17.44
|
| Rate for Payer: BCBS MAPPO |
$26.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,192.37
|
| Rate for Payer: BCN Commercial |
$74.21
|
| Rate for Payer: BCN Medicare Advantage |
$26.13
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cofinity Commercial |
$35.01
|
| Rate for Payer: Cofinity Commercial |
$37.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.13
|
| Rate for Payer: Mclaren Medicaid |
$16.61
|
| Rate for Payer: Meridian Medicaid |
$17.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.44
|
| Rate for Payer: PACE SWMI |
$26.13
|
| Rate for Payer: PHP Medicare Advantage |
$26.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.83
|
| Rate for Payer: Priority Health Medicare |
$26.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.13
|
| Rate for Payer: UHC Medicare Advantage |
$26.91
|
|
|
PR STRTCTC BX ASPIR/EXC BURR ICRA LESION W/CT&I/MR
|
Professional
|
Both
|
$6,896.00
|
|
|
Service Code
|
HCPCS 61751
|
| Min. Negotiated Rate |
$741.20 |
| Max. Negotiated Rate |
$4,827.20 |
| Rate for Payer: Aetna Commercial |
$1,870.16
|
| Rate for Payer: Aetna Medicare |
$1,451.47
|
| Rate for Payer: BCBS Complete |
$949.17
|
| Rate for Payer: BCBS MAPPO |
$1,395.64
|
| Rate for Payer: BCBS Trust/PPO |
$741.20
|
| Rate for Payer: BCN Commercial |
$2,847.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,395.64
|
| Rate for Payer: Cash Price |
$5,516.80
|
| Rate for Payer: Cash Price |
$5,516.80
|
| Rate for Payer: Cofinity Commercial |
$1,870.16
|
| Rate for Payer: Cofinity Commercial |
$2,009.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,395.64
|
| Rate for Payer: Mclaren Medicaid |
$903.97
|
| Rate for Payer: Meridian Medicaid |
$949.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,465.42
|
| Rate for Payer: PACE SWMI |
$1,395.64
|
| Rate for Payer: PHP Medicare Advantage |
$1,395.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$903.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,827.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,378.13
|
| Rate for Payer: Priority Health Medicare |
$1,395.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,378.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,395.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,395.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,437.51
|
|
|
PR STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL
|
Professional
|
Both
|
$728.00
|
|
|
Service Code
|
HCPCS 61781
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$698.41 |
| Rate for Payer: Aetna Commercial |
$318.52
|
| Rate for Payer: Aetna Medicare |
$247.21
|
| Rate for Payer: BCBS Complete |
$158.34
|
| Rate for Payer: BCBS MAPPO |
$237.70
|
| Rate for Payer: BCBS Trust/PPO |
$698.41
|
| Rate for Payer: BCN Commercial |
$345.01
|
| Rate for Payer: BCN Medicare Advantage |
$237.70
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cofinity Commercial |
$342.29
|
| Rate for Payer: Cofinity Commercial |
$318.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.70
|
| Rate for Payer: Mclaren Medicaid |
$150.80
|
| Rate for Payer: Meridian Medicaid |
$158.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$249.58
|
| Rate for Payer: PACE SWMI |
$237.70
|
| Rate for Payer: PHP Medicare Advantage |
$237.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$399.75
|
| Rate for Payer: Priority Health Medicare |
$237.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$399.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.70
|
| Rate for Payer: UHC Medicare Advantage |
$244.83
|
|
