|
PR INSRT CH WALL RESPIR ELTRD/RA & CONJ PULSE GEN
|
Professional
|
Both
|
$485.00
|
|
|
Service Code
|
HCPCS 0466T
|
| Min. Negotiated Rate |
$194.00 |
| Max. Negotiated Rate |
$315.25 |
| Rate for Payer: Aetna Medicare |
$242.50
|
| Rate for Payer: BCBS Complete |
$194.00
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.25
|
|
|
PR INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 32562
|
| Min. Negotiated Rate |
$56.83 |
| Max. Negotiated Rate |
$138.45 |
| Rate for Payer: Aetna Commercial |
$76.15
|
| Rate for Payer: Aetna Medicare |
$59.10
|
| Rate for Payer: BCBS Complete |
$85.20
|
| Rate for Payer: BCBS MAPPO |
$56.83
|
| Rate for Payer: BCN Medicare Advantage |
$56.83
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$81.84
|
| Rate for Payer: Cofinity Commercial |
$76.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.67
|
| Rate for Payer: Nomi Health Commercial |
$68.20
|
| Rate for Payer: PACE SWMI |
$56.83
|
| Rate for Payer: PHP Medicare Advantage |
$56.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.45
|
| Rate for Payer: Priority Health Medicare |
$57.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.83
|
| Rate for Payer: UHC Exchange |
$56.83
|
| Rate for Payer: UHC Medicare Advantage |
$56.83
|
|
|
PR INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS
|
Professional
|
Both
|
$455.00
|
|
|
Service Code
|
HCPCS 32560
|
| Min. Negotiated Rate |
$72.39 |
| Max. Negotiated Rate |
$295.75 |
| Rate for Payer: Aetna Commercial |
$97.00
|
| Rate for Payer: Aetna Medicare |
$75.29
|
| Rate for Payer: BCBS Complete |
$182.00
|
| Rate for Payer: BCBS MAPPO |
$72.39
|
| Rate for Payer: BCN Medicare Advantage |
$72.39
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cofinity Commercial |
$97.00
|
| Rate for Payer: Cofinity Commercial |
$104.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.01
|
| Rate for Payer: Nomi Health Commercial |
$86.87
|
| Rate for Payer: PACE SWMI |
$72.39
|
| Rate for Payer: PHP Medicare Advantage |
$72.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.75
|
| Rate for Payer: Priority Health Medicare |
$73.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.39
|
| Rate for Payer: UHC Exchange |
$72.39
|
| Rate for Payer: UHC Medicare Advantage |
$72.39
|
|
|
PR INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY
|
Professional
|
Both
|
$230.00
|
|
|
Service Code
|
HCPCS 32561
|
| Min. Negotiated Rate |
$64.00 |
| Max. Negotiated Rate |
$149.50 |
| Rate for Payer: Aetna Commercial |
$85.76
|
| Rate for Payer: Aetna Medicare |
$66.56
|
| Rate for Payer: BCBS Complete |
$92.00
|
| Rate for Payer: BCBS MAPPO |
$64.00
|
| Rate for Payer: BCN Medicare Advantage |
$64.00
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cofinity Commercial |
$92.16
|
| Rate for Payer: Cofinity Commercial |
$85.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.20
|
| Rate for Payer: Nomi Health Commercial |
$76.80
|
| Rate for Payer: PACE SWMI |
$64.00
|
| Rate for Payer: PHP Medicare Advantage |
$64.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.50
|
| Rate for Payer: Priority Health Medicare |
$64.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.00
|
| Rate for Payer: UHC Exchange |
$64.00
|
| Rate for Payer: UHC Medicare Advantage |
$64.00
|
|
|
PR INSTRUMENT BASED OCULAR SCR BI W/ONSITE ANALYSIS
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 99177
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$7.15 |
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
|
|
PR INSTRUMENT BASED OCULAR SCR BI W/RMT ANAL & RPT
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 99174
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
|
|
PR INSULIN INJECTION
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS J1815
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$20.15 |
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
|
|
PR INT ANAST PANCREATIC CYST GI TRACT DIRECT
|
Professional
|
Both
|
$1,966.00
|
|
|
Service Code
|
HCPCS 48520
|
| Min. Negotiated Rate |
$786.40 |
| Max. Negotiated Rate |
$1,539.86 |
| Rate for Payer: Aetna Commercial |
$1,432.93
|
| Rate for Payer: Aetna Medicare |
$1,112.12
|
| Rate for Payer: BCBS Complete |
$786.40
|
| Rate for Payer: BCBS MAPPO |
$1,069.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,069.35
|
| Rate for Payer: Cash Price |
$1,572.80
|
| Rate for Payer: Cash Price |
$1,572.80
|
| Rate for Payer: Cofinity Commercial |
$1,432.93
|
| Rate for Payer: Cofinity Commercial |
$1,539.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,069.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,122.82
|
| Rate for Payer: Nomi Health Commercial |
$1,283.22
|
| Rate for Payer: PACE SWMI |
$1,069.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,069.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,277.90
|
| Rate for Payer: Priority Health Medicare |
$1,080.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,069.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,069.35
|
| Rate for Payer: UHC Exchange |
$1,069.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,069.35
|
|
|
PR INT ANAST PANCREATIC CYST GI TRACT ROUX-EN-Y
|
Professional
|
Both
|
$2,887.00
|
|
|
Service Code
|
HCPCS 48540
|
| Min. Negotiated Rate |
$1,154.80 |
| Max. Negotiated Rate |
$1,876.55 |
| Rate for Payer: Aetna Commercial |
$1,704.52
|
| Rate for Payer: Aetna Medicare |
$1,322.91
|
| Rate for Payer: BCBS Complete |
$1,154.80
|
| Rate for Payer: BCBS MAPPO |
$1,272.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,272.03
|
| Rate for Payer: Cash Price |
$2,309.60
|
| Rate for Payer: Cash Price |
$2,309.60
|
| Rate for Payer: Cofinity Commercial |
$1,831.72
|
| Rate for Payer: Cofinity Commercial |
$1,704.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,272.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,335.63
|
| Rate for Payer: Nomi Health Commercial |
$1,526.44
|
| Rate for Payer: PACE SWMI |
$1,272.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,272.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,876.55
|
| Rate for Payer: Priority Health Medicare |
$1,284.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,272.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,272.03
|
| Rate for Payer: UHC Exchange |
$1,272.03
|
| Rate for Payer: UHC Medicare Advantage |
$1,272.03
|
|
|
PR INTENSIVE OUTPATIENT PSYCHIA
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS S9480
|
| Min. Negotiated Rate |
$52.00 |
| Max. Negotiated Rate |
$84.50 |
| Rate for Payer: Aetna Medicare |
$65.00
|
| Rate for Payer: BCBS Complete |
$52.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.50
|
|
|
PR INTER DEVC REMOTE 30D
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS G2066
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$27.30 |
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
|
|
PR INTERMITTENT URINARY CATH
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS A4353
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$14.10 |
| Rate for Payer: Aetna Commercial |
$13.12
|
| Rate for Payer: Aetna Medicare |
$10.18
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$9.79
|
| Rate for Payer: BCN Medicare Advantage |
$9.79
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$13.12
|
| Rate for Payer: Cofinity Commercial |
$14.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.28
|
| Rate for Payer: Nomi Health Commercial |
$11.75
|
| Rate for Payer: PACE SWMI |
$9.79
|
| Rate for Payer: PHP Medicare Advantage |
$9.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
| Rate for Payer: Priority Health Medicare |
$9.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.79
|
| Rate for Payer: UHC Exchange |
$9.79
|
| Rate for Payer: UHC Medicare Advantage |
$9.79
|
|
|
PR INTERNAL NEUROLYSIS REQ OPERATING MICROSCOPE
|
Professional
|
Both
|
$750.00
|
|
|
Service Code
|
HCPCS 64727
|
| Min. Negotiated Rate |
$168.44 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$225.71
|
| Rate for Payer: Aetna Medicare |
$175.18
|
| Rate for Payer: BCBS Complete |
$300.00
|
| Rate for Payer: BCBS MAPPO |
$168.44
|
| Rate for Payer: BCN Medicare Advantage |
$168.44
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cofinity Commercial |
$242.55
|
| Rate for Payer: Cofinity Commercial |
$225.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.86
|
| Rate for Payer: Nomi Health Commercial |
$202.13
|
| Rate for Payer: PACE SWMI |
$168.44
|
| Rate for Payer: PHP Medicare Advantage |
$168.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.50
|
| Rate for Payer: Priority Health Medicare |
$170.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$168.44
|
| Rate for Payer: UHC Exchange |
$168.44
|
| Rate for Payer: UHC Medicare Advantage |
$168.44
|
|
|
PR INTERNAL SPINAL FIXATION WIRING SPINOUS PROCESS
|
Professional
|
Both
|
$1,218.00
|
|
|
Service Code
|
HCPCS 22841
|
| Min. Negotiated Rate |
$487.20 |
| Max. Negotiated Rate |
$791.70 |
| Rate for Payer: Aetna Medicare |
$609.00
|
| Rate for Payer: BCBS Complete |
$487.20
|
| Rate for Payer: Cash Price |
$974.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$791.70
|
|
|
PR INTERPELVIABDOMINAL AMPUTATION
|
Professional
|
Both
|
$5,330.00
|
|
|
Service Code
|
HCPCS 27290
|
| Min. Negotiated Rate |
$1,562.82 |
| Max. Negotiated Rate |
$3,464.50 |
| Rate for Payer: Aetna Commercial |
$2,094.18
|
| Rate for Payer: Aetna Medicare |
$1,625.33
|
| Rate for Payer: BCBS Complete |
$2,132.00
|
| Rate for Payer: BCBS MAPPO |
$1,562.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,562.82
|
| Rate for Payer: Cash Price |
$4,264.00
|
| Rate for Payer: Cash Price |
$4,264.00
|
| Rate for Payer: Cofinity Commercial |
$2,250.46
|
| Rate for Payer: Cofinity Commercial |
$2,094.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,562.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,640.96
|
| Rate for Payer: Nomi Health Commercial |
$1,875.38
|
| Rate for Payer: PACE SWMI |
$1,562.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,562.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,464.50
|
| Rate for Payer: Priority Health Medicare |
$1,578.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,562.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,562.82
|
| Rate for Payer: UHC Exchange |
$1,562.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,562.82
|
|
|
PR INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM FAMILY
|
Professional
|
Both
|
$152.00
|
|
|
Service Code
|
HCPCS 90887
|
| Min. Negotiated Rate |
$60.80 |
| Max. Negotiated Rate |
$98.80 |
| Rate for Payer: Aetna Medicare |
$76.00
|
| Rate for Payer: BCBS Complete |
$60.80
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.80
|
|
|
PR INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 93261
|
| Min. Negotiated Rate |
$54.40 |
| Max. Negotiated Rate |
$91.70 |
| Rate for Payer: Aetna Commercial |
$85.33
|
| Rate for Payer: Aetna Medicare |
$66.23
|
| Rate for Payer: BCBS Complete |
$54.40
|
| Rate for Payer: BCBS MAPPO |
$63.68
|
| Rate for Payer: BCN Medicare Advantage |
$63.68
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Commercial |
$91.70
|
| Rate for Payer: Cofinity Commercial |
$85.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.86
|
| Rate for Payer: Nomi Health Commercial |
$76.42
|
| Rate for Payer: PACE SWMI |
$63.68
|
| Rate for Payer: PHP Medicare Advantage |
$63.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.40
|
| Rate for Payer: Priority Health Medicare |
$64.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.68
|
| Rate for Payer: UHC Exchange |
$63.68
|
| Rate for Payer: UHC Medicare Advantage |
$63.68
|
|
|
PR INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 93292
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$66.23 |
| Rate for Payer: Aetna Commercial |
$61.63
|
| Rate for Payer: Aetna Medicare |
$47.83
|
| Rate for Payer: BCBS Complete |
$25.60
|
| Rate for Payer: BCBS MAPPO |
$45.99
|
| Rate for Payer: BCN Medicare Advantage |
$45.99
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$61.63
|
| Rate for Payer: Cofinity Commercial |
$66.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.29
|
| Rate for Payer: Nomi Health Commercial |
$55.19
|
| Rate for Payer: PACE SWMI |
$45.99
|
| Rate for Payer: PHP Medicare Advantage |
$45.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.60
|
| Rate for Payer: Priority Health Medicare |
$46.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.99
|
| Rate for Payer: UHC Exchange |
$45.99
|
| Rate for Payer: UHC Medicare Advantage |
$45.99
|
|
|
PR INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 93295
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$130.65 |
| Rate for Payer: Aetna Commercial |
$45.56
|
| Rate for Payer: Aetna Medicare |
$35.36
|
| Rate for Payer: BCBS Complete |
$80.40
|
| Rate for Payer: BCBS MAPPO |
$34.00
|
| Rate for Payer: BCN Medicare Advantage |
$34.00
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cofinity Commercial |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$45.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.70
|
| Rate for Payer: Nomi Health Commercial |
$40.80
|
| Rate for Payer: PACE SWMI |
$34.00
|
| Rate for Payer: PHP Medicare Advantage |
$34.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health Medicare |
$34.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.00
|
| Rate for Payer: UHC Exchange |
$34.00
|
| Rate for Payer: UHC Medicare Advantage |
$34.00
|
|
|
PR INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 93290
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$68.34 |
| Rate for Payer: Aetna Commercial |
$63.60
|
| Rate for Payer: Aetna Medicare |
$49.36
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: BCBS MAPPO |
$47.46
|
| Rate for Payer: BCN Medicare Advantage |
$47.46
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$68.34
|
| Rate for Payer: Cofinity Commercial |
$63.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.83
|
| Rate for Payer: Nomi Health Commercial |
$56.95
|
| Rate for Payer: PACE SWMI |
$47.46
|
| Rate for Payer: PHP Medicare Advantage |
$47.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| Rate for Payer: Priority Health Medicare |
$47.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.46
|
| Rate for Payer: UHC Exchange |
$47.46
|
| Rate for Payer: UHC Medicare Advantage |
$47.46
|
|
|
PR INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 93288
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$111.15 |
| Rate for Payer: Aetna Commercial |
$67.43
|
| Rate for Payer: Aetna Commercial |
$67.43
|
| Rate for Payer: Aetna Medicare |
$52.33
|
| Rate for Payer: Aetna Medicare |
$52.33
|
| Rate for Payer: BCBS Complete |
$68.40
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$50.32
|
| Rate for Payer: BCBS MAPPO |
$50.32
|
| Rate for Payer: BCN Medicare Advantage |
$50.32
|
| Rate for Payer: BCN Medicare Advantage |
$50.32
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cofinity Commercial |
$72.46
|
| Rate for Payer: Cofinity Commercial |
$67.43
|
| Rate for Payer: Cofinity Commercial |
$72.46
|
| Rate for Payer: Cofinity Commercial |
$67.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.84
|
| Rate for Payer: Nomi Health Commercial |
$60.38
|
| Rate for Payer: Nomi Health Commercial |
$60.38
|
| Rate for Payer: PACE SWMI |
$50.32
|
| Rate for Payer: PACE SWMI |
$50.32
|
| Rate for Payer: PHP Medicare Advantage |
$50.32
|
| Rate for Payer: PHP Medicare Advantage |
$50.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Medicare |
$50.82
|
| Rate for Payer: Priority Health Medicare |
$50.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.32
|
| Rate for Payer: UHC Exchange |
$50.32
|
| Rate for Payer: UHC Exchange |
$50.32
|
| Rate for Payer: UHC Medicare Advantage |
$50.32
|
| Rate for Payer: UHC Medicare Advantage |
$50.32
|
|
|
PR INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 93291
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$62.88 |
| Rate for Payer: Aetna Commercial |
$58.52
|
| Rate for Payer: Aetna Medicare |
$45.42
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: BCBS MAPPO |
$43.67
|
| Rate for Payer: BCN Medicare Advantage |
$43.67
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$62.88
|
| Rate for Payer: Cofinity Commercial |
$58.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.85
|
| Rate for Payer: Nomi Health Commercial |
$52.40
|
| Rate for Payer: PACE SWMI |
$43.67
|
| Rate for Payer: PHP Medicare Advantage |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: Priority Health Medicare |
$44.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.67
|
| Rate for Payer: UHC Exchange |
$43.67
|
| Rate for Payer: UHC Medicare Advantage |
$43.67
|
|
|
PR INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB
|
Professional
|
Both
|
$206.00
|
|
|
Service Code
|
HCPCS 93289
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$133.90 |
| Rate for Payer: Aetna Commercial |
$87.06
|
| Rate for Payer: Aetna Medicare |
$67.57
|
| Rate for Payer: BCBS Complete |
$82.40
|
| Rate for Payer: BCBS MAPPO |
$64.97
|
| Rate for Payer: BCN Medicare Advantage |
$64.97
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$93.56
|
| Rate for Payer: Cofinity Commercial |
$87.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.22
|
| Rate for Payer: Nomi Health Commercial |
$77.96
|
| Rate for Payer: PACE SWMI |
$64.97
|
| Rate for Payer: PHP Medicare Advantage |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.90
|
| Rate for Payer: Priority Health Medicare |
$65.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.97
|
| Rate for Payer: UHC Exchange |
$64.97
|
| Rate for Payer: UHC Medicare Advantage |
$64.97
|
|
|
PR INTERTHORACOSCAPULAR AMPUTATION
|
Professional
|
Both
|
$5,989.00
|
|
|
Service Code
|
HCPCS 23900
|
| Min. Negotiated Rate |
$1,333.90 |
| Max. Negotiated Rate |
$3,892.85 |
| Rate for Payer: Aetna Commercial |
$1,787.43
|
| Rate for Payer: Aetna Medicare |
$1,387.26
|
| Rate for Payer: BCBS Complete |
$2,395.60
|
| Rate for Payer: BCBS MAPPO |
$1,333.90
|
| Rate for Payer: BCN Medicare Advantage |
$1,333.90
|
| Rate for Payer: Cash Price |
$4,791.20
|
| Rate for Payer: Cash Price |
$4,791.20
|
| Rate for Payer: Cofinity Commercial |
$1,920.82
|
| Rate for Payer: Cofinity Commercial |
$1,787.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,333.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,400.60
|
| Rate for Payer: Nomi Health Commercial |
$1,600.68
|
| Rate for Payer: PACE SWMI |
$1,333.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,333.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,892.85
|
| Rate for Payer: Priority Health Medicare |
$1,347.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,333.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,333.90
|
| Rate for Payer: UHC Exchange |
$1,333.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,333.90
|
|
|
PR INTESTINAL PLICATION SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,967.00
|
|
|
Service Code
|
HCPCS 44680
|
| Min. Negotiated Rate |
$1,048.51 |
| Max. Negotiated Rate |
$1,928.55 |
| Rate for Payer: Aetna Commercial |
$1,405.00
|
| Rate for Payer: Aetna Medicare |
$1,090.45
|
| Rate for Payer: BCBS Complete |
$1,186.80
|
| Rate for Payer: BCBS MAPPO |
$1,048.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.51
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Cash Price |
$2,373.60
|
| Rate for Payer: Cofinity Commercial |
$1,509.85
|
| Rate for Payer: Cofinity Commercial |
$1,405.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,100.94
|
| Rate for Payer: Nomi Health Commercial |
$1,258.21
|
| Rate for Payer: PACE SWMI |
$1,048.51
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,928.55
|
| Rate for Payer: Priority Health Medicare |
$1,059.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,048.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.51
|
| Rate for Payer: UHC Exchange |
$1,048.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,048.51
|
|
