|
PR NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 96133
|
| Min. Negotiated Rate |
$44.94 |
| Max. Negotiated Rate |
$156.75 |
| Rate for Payer: Aetna Commercial |
$88.51
|
| Rate for Payer: Aetna Medicare |
$104.50
|
| Rate for Payer: BCBS Complete |
$47.19
|
| Rate for Payer: BCN Commercial |
$143.92
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Mclaren Medicaid |
$44.94
|
| Rate for Payer: Meridian Medicaid |
$47.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$103.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.33
|
| Rate for Payer: UHC Medicaid |
$44.94
|
| Rate for Payer: UHCCP Medicaid |
$44.94
|
|
|
PR NEUROPSYCH TESTING BY COMPUTER
|
Professional
|
Both
|
$177.00
|
|
|
Service Code
|
HCPCS 96120
|
| Min. Negotiated Rate |
$70.80 |
| Max. Negotiated Rate |
$132.75 |
| Rate for Payer: Aetna Medicare |
$88.50
|
| Rate for Payer: BCBS Complete |
$70.80
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.75
|
|
|
PR NEUROPSYCH TESTING BY PSYCH/PHYS
|
Professional
|
Both
|
$230.00
|
|
|
Service Code
|
HCPCS 96118
|
| Min. Negotiated Rate |
$92.00 |
| Max. Negotiated Rate |
$172.50 |
| Rate for Payer: Aetna Medicare |
$115.00
|
| Rate for Payer: BCBS Complete |
$92.00
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.50
|
|
|
PR NEUROPSYCH TESTING BY TECHNICIAN
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 96119
|
| Min. Negotiated Rate |
$51.60 |
| Max. Negotiated Rate |
$96.75 |
| Rate for Payer: Aetna Medicare |
$64.50
|
| Rate for Payer: BCBS Complete |
$51.60
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
|
|
PR NEURP MAJOR PRPH NRV ARM/LEG OPN OTH/THN SPEC
|
Professional
|
Both
|
$2,725.00
|
|
|
Service Code
|
HCPCS 64708
|
| Min. Negotiated Rate |
$296.07 |
| Max. Negotiated Rate |
$2,043.75 |
| Rate for Payer: Aetna Commercial |
$649.68
|
| Rate for Payer: Aetna Medicare |
$1,362.50
|
| Rate for Payer: BCBS Complete |
$310.87
|
| Rate for Payer: BCN Commercial |
$772.37
|
| Rate for Payer: Cash Price |
$2,180.00
|
| Rate for Payer: Cash Price |
$2,180.00
|
| Rate for Payer: Mclaren Medicaid |
$296.07
|
| Rate for Payer: Meridian Medicaid |
$310.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,043.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$296.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$897.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$897.08
|
| Rate for Payer: UHC Medicaid |
$296.07
|
| Rate for Payer: UHCCP Medicaid |
$296.07
|
|
|
PR NEURP MAJOR PRPH NRV OPN ARM/LEG BRACH PLEXUS
|
Professional
|
Both
|
$2,857.00
|
|
|
Service Code
|
HCPCS 64713
|
| Min. Negotiated Rate |
$475.20 |
| Max. Negotiated Rate |
$2,142.75 |
| Rate for Payer: Aetna Commercial |
$1,010.20
|
| Rate for Payer: Aetna Medicare |
$1,428.50
|
| Rate for Payer: BCBS Complete |
$498.96
|
| Rate for Payer: BCN Commercial |
$1,215.57
|
| Rate for Payer: Cash Price |
$2,285.60
|
| Rate for Payer: Cash Price |
$2,285.60
|
| Rate for Payer: Mclaren Medicaid |
$475.20
|
| Rate for Payer: Meridian Medicaid |
$498.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,142.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$475.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,411.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,411.87
|
| Rate for Payer: UHC Medicaid |
$475.20
|
| Rate for Payer: UHCCP Medicaid |
$475.20
|
|
|
PR NEURP MAJOR PRPH NRV OPN ARM/LEG LMBR PLEXUS
|
Professional
|
Both
|
$3,510.00
|
|
|
Service Code
|
HCPCS 64714
|
| Min. Negotiated Rate |
$456.46 |
| Max. Negotiated Rate |
$2,632.50 |
| Rate for Payer: Aetna Commercial |
$974.07
|
| Rate for Payer: Aetna Medicare |
$1,755.00
|
| Rate for Payer: BCBS Complete |
$479.28
|
| Rate for Payer: BCN Commercial |
$1,166.77
|
| Rate for Payer: Cash Price |
$2,808.00
|
| Rate for Payer: Cash Price |
$2,808.00
|
| Rate for Payer: Mclaren Medicaid |
$456.46
|
| Rate for Payer: Meridian Medicaid |
$479.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,632.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$456.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,355.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,355.18
|
| Rate for Payer: UHC Medicaid |
$456.46
|
| Rate for Payer: UHCCP Medicaid |
$456.46
|
|
|
PR NEURP MAJOR PRPH NRV OPN ARM/LEG SCIATIC NRV
|
Professional
|
Both
|
$1,027.00
|
|
|
Service Code
|
HCPCS 64712
|
| Min. Negotiated Rate |
$355.50 |
| Max. Negotiated Rate |
$1,050.95 |
| Rate for Payer: Aetna Commercial |
$761.95
|
| Rate for Payer: Aetna Medicare |
$513.50
|
| Rate for Payer: BCBS Complete |
$373.27
|
| Rate for Payer: BCN Commercial |
$904.83
|
| Rate for Payer: Cash Price |
$821.60
|
| Rate for Payer: Cash Price |
$821.60
|
| Rate for Payer: Mclaren Medicaid |
$355.50
|
| Rate for Payer: Meridian Medicaid |
$373.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$770.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$355.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,050.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,050.95
|
| Rate for Payer: UHC Medicaid |
$355.50
|
| Rate for Payer: UHCCP Medicaid |
$355.50
|
|
|
PR N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI
|
Professional
|
Both
|
$329.00
|
|
|
Service Code
|
HCPCS 93924
|
| Min. Negotiated Rate |
$164.50 |
| Max. Negotiated Rate |
$246.75 |
| Rate for Payer: Aetna Commercial |
$172.82
|
| Rate for Payer: Aetna Medicare |
$164.50
|
| Rate for Payer: BCN Commercial |
$237.54
|
| Rate for Payer: Cash Price |
$263.20
|
| Rate for Payer: Cash Price |
$263.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$219.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.06
|
|
|
PR NIPPLE/AREOLA RECONSTRUCTION
|
Professional
|
Both
|
$1,576.00
|
|
|
Service Code
|
HCPCS 19350
|
| Min. Negotiated Rate |
$392.77 |
| Max. Negotiated Rate |
$1,182.00 |
| Rate for Payer: Aetna Commercial |
$725.23
|
| Rate for Payer: Aetna Medicare |
$788.00
|
| Rate for Payer: BCBS Complete |
$412.41
|
| Rate for Payer: BCN Commercial |
$1,020.86
|
| Rate for Payer: Cash Price |
$1,260.80
|
| Rate for Payer: Cash Price |
$1,260.80
|
| Rate for Payer: Mclaren Medicaid |
$392.77
|
| Rate for Payer: Meridian Medicaid |
$412.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,182.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$934.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$934.35
|
| Rate for Payer: UHC Medicaid |
$392.77
|
| Rate for Payer: UHCCP Medicaid |
$392.77
|
|
|
PR NIPPLE EXPLORATION
|
Professional
|
Both
|
$791.00
|
|
|
Service Code
|
HCPCS 19110
|
| Min. Negotiated Rate |
$226.85 |
| Max. Negotiated Rate |
$593.25 |
| Rate for Payer: Aetna Commercial |
$381.31
|
| Rate for Payer: Aetna Medicare |
$395.50
|
| Rate for Payer: BCBS Complete |
$238.19
|
| Rate for Payer: BCN Commercial |
$537.33
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Cash Price |
$632.80
|
| Rate for Payer: Mclaren Medicaid |
$226.85
|
| Rate for Payer: Meridian Medicaid |
$238.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$593.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$491.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$491.79
|
| Rate for Payer: UHC Medicaid |
$226.85
|
| Rate for Payer: UHCCP Medicaid |
$226.85
|
|
|
PR NITRIC OXIDE EXPIRED GAS DETERMINATION
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS 95012
|
| Min. Negotiated Rate |
$18.50 |
| Max. Negotiated Rate |
$27.89 |
| Rate for Payer: Aetna Commercial |
$19.38
|
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: BCN Commercial |
$27.89
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.24
|
|
|
PR NJX AA&/STRD PLANTAR COMMON DIGITAL NERVES
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 64455
|
| Min. Negotiated Rate |
$19.17 |
| Max. Negotiated Rate |
$245.25 |
| Rate for Payer: Aetna Commercial |
$43.68
|
| Rate for Payer: Aetna Medicare |
$163.50
|
| Rate for Payer: BCBS Complete |
$20.13
|
| Rate for Payer: BCN Commercial |
$49.30
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Mclaren Medicaid |
$19.17
|
| Rate for Payer: Meridian Medicaid |
$20.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$57.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.26
|
| Rate for Payer: UHC Medicaid |
$19.17
|
| Rate for Payer: UHCCP Medicaid |
$19.17
|
|
|
PR NJX AA&/STRD TFRML EPI CERVICAL/THORACIC 1 LEVEL
|
Professional
|
Both
|
$920.00
|
|
|
Service Code
|
HCPCS 64479
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$690.00 |
| Rate for Payer: Aetna Commercial |
$167.75
|
| Rate for Payer: Aetna Commercial |
$167.75
|
| Rate for Payer: Aetna Medicare |
$460.00
|
| Rate for Payer: Aetna Medicare |
$163.50
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCN Commercial |
$195.21
|
| Rate for Payer: BCN Commercial |
$195.21
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Cash Price |
$736.00
|
| Rate for Payer: Mclaren Medicaid |
$74.34
|
| Rate for Payer: Mclaren Medicaid |
$74.34
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$690.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.73
|
| Rate for Payer: UHC Medicaid |
$74.34
|
| Rate for Payer: UHC Medicaid |
$74.34
|
| Rate for Payer: UHCCP Medicaid |
$74.34
|
| Rate for Payer: UHCCP Medicaid |
$74.34
|
|
|
PR NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL
|
Professional
|
Both
|
$356.00
|
|
|
Service Code
|
HCPCS 64480
|
| Min. Negotiated Rate |
$33.87 |
| Max. Negotiated Rate |
$267.00 |
| Rate for Payer: Aetna Commercial |
$80.46
|
| Rate for Payer: Aetna Medicare |
$178.00
|
| Rate for Payer: BCBS Complete |
$35.56
|
| Rate for Payer: BCN Commercial |
$91.63
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Cash Price |
$284.80
|
| Rate for Payer: Mclaren Medicaid |
$33.87
|
| Rate for Payer: Meridian Medicaid |
$35.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$106.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.43
|
| Rate for Payer: UHC Medicaid |
$33.87
|
| Rate for Payer: UHCCP Medicaid |
$33.87
|
|
|
PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS 64483
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Aetna Commercial |
$142.50
|
| Rate for Payer: Aetna Commercial |
$142.50
|
| Rate for Payer: Aetna Medicare |
$139.00
|
| Rate for Payer: Aetna Medicare |
$525.50
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCN Commercial |
$165.83
|
| Rate for Payer: BCN Commercial |
$165.83
|
| Rate for Payer: Cash Price |
$840.80
|
| Rate for Payer: Cash Price |
$840.80
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Mclaren Medicaid |
$63.47
|
| Rate for Payer: Mclaren Medicaid |
$63.47
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$788.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$192.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$192.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$192.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$192.60
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL
|
Professional
|
Both
|
$458.00
|
|
|
Service Code
|
HCPCS 64484
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$343.50 |
| Rate for Payer: Aetna Commercial |
$67.16
|
| Rate for Payer: Aetna Medicare |
$229.00
|
| Rate for Payer: BCBS Complete |
$29.30
|
| Rate for Payer: BCN Commercial |
$75.19
|
| Rate for Payer: Cash Price |
$366.40
|
| Rate for Payer: Cash Price |
$366.40
|
| Rate for Payer: Mclaren Medicaid |
$27.90
|
| Rate for Payer: Meridian Medicaid |
$29.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$343.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.33
|
| Rate for Payer: UHC Medicaid |
$27.90
|
| Rate for Payer: UHCCP Medicaid |
$27.90
|
|
|
PR NJX BONE SUB MATRL INTO SUBCHONDRAL BONE DEFECT
|
Professional
|
Both
|
$3,152.00
|
|
|
Service Code
|
HCPCS 0707T
|
| Min. Negotiated Rate |
$368.07 |
| Max. Negotiated Rate |
$3,033.71 |
| Rate for Payer: Aetna Commercial |
$368.07
|
| Rate for Payer: Aetna Medicare |
$1,576.00
|
| Rate for Payer: BCBS Complete |
$1,260.80
|
| Rate for Payer: BCN Commercial |
$3,033.71
|
| Rate for Payer: Cash Price |
$2,521.60
|
| Rate for Payer: Cash Price |
$2,521.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,364.00
|
|
|
PR NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY
|
Professional
|
Both
|
$710.00
|
|
|
Service Code
|
HCPCS 51600
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$532.50 |
| Rate for Payer: Aetna Commercial |
$56.72
|
| Rate for Payer: Aetna Medicare |
$355.00
|
| Rate for Payer: BCBS Complete |
$25.05
|
| Rate for Payer: BCN Commercial |
$63.74
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Mclaren Medicaid |
$23.86
|
| Rate for Payer: Meridian Medicaid |
$25.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$532.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.43
|
| Rate for Payer: UHC Medicaid |
$23.86
|
| Rate for Payer: UHCCP Medicaid |
$23.86
|
|
|
PR NJX DRG C-CATHJ SLCTV L VNTRC/L ATRIAL ANGRPHS&I
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 93565
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$59.84 |
| Rate for Payer: Aetna Commercial |
$59.84
|
| Rate for Payer: Aetna Medicare |
$38.50
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCN Commercial |
$39.84
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Mclaren Medicaid |
$14.91
|
| Rate for Payer: Meridian Medicaid |
$15.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.87
|
| Rate for Payer: UHC Medicaid |
$14.91
|
| Rate for Payer: UHCCP Medicaid |
$14.91
|
|
|
PR NJX DRG C-CATHJ SLCTV R VNTRC/R ATRIAL ANGRPHS&I
|
Professional
|
Both
|
$297.00
|
|
|
Service Code
|
HCPCS 93566
|
| Min. Negotiated Rate |
$14.27 |
| Max. Negotiated Rate |
$222.75 |
| Rate for Payer: Aetna Commercial |
$60.76
|
| Rate for Payer: Aetna Medicare |
$148.50
|
| Rate for Payer: BCBS Complete |
$14.98
|
| Rate for Payer: BCN Commercial |
$37.85
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Mclaren Medicaid |
$14.27
|
| Rate for Payer: Meridian Medicaid |
$14.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.97
|
| Rate for Payer: UHC Medicaid |
$14.27
|
| Rate for Payer: UHCCP Medicaid |
$14.27
|
|
|
PR NJX DRG C-CATHJ SUPRAVALVULAR AORTOGRAPHY S&I
|
Professional
|
Both
|
$440.00
|
|
|
Service Code
|
HCPCS 93567
|
| Min. Negotiated Rate |
$20.66 |
| Max. Negotiated Rate |
$330.00 |
| Rate for Payer: Aetna Commercial |
$69.97
|
| Rate for Payer: Aetna Medicare |
$220.00
|
| Rate for Payer: BCBS Complete |
$21.69
|
| Rate for Payer: BCN Commercial |
$54.78
|
| Rate for Payer: Cash Price |
$352.00
|
| Rate for Payer: Cash Price |
$352.00
|
| Rate for Payer: Mclaren Medicaid |
$20.66
|
| Rate for Payer: Meridian Medicaid |
$21.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$330.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.06
|
| Rate for Payer: UHC Medicaid |
$20.66
|
| Rate for Payer: UHCCP Medicaid |
$20.66
|
|
|
PR NJX DRG CGEN C-CATHJ SLCTV CORONARY ANGRPH S&I
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 93563
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$76.86
|
| Rate for Payer: Aetna Medicare |
$63.00
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCN Commercial |
$75.19
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Mclaren Medicaid |
$28.33
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.46
|
| Rate for Payer: UHC Medicaid |
$28.33
|
| Rate for Payer: UHCCP Medicaid |
$28.33
|
|
|
PR NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL
|
Professional
|
Both
|
$349.00
|
|
|
Service Code
|
HCPCS 64490
|
| Min. Negotiated Rate |
$60.07 |
| Max. Negotiated Rate |
$261.75 |
| Rate for Payer: Aetna Commercial |
$135.62
|
| Rate for Payer: Aetna Medicare |
$174.50
|
| Rate for Payer: BCBS Complete |
$63.07
|
| Rate for Payer: BCN Commercial |
$157.36
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Mclaren Medicaid |
$60.07
|
| Rate for Payer: Meridian Medicaid |
$63.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$182.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.76
|
| Rate for Payer: UHC Medicaid |
$60.07
|
| Rate for Payer: UHCCP Medicaid |
$60.07
|
|
|
PR NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL
|
Professional
|
Both
|
$218.00
|
|
|
Service Code
|
HCPCS 64491
|
| Min. Negotiated Rate |
$32.38 |
| Max. Negotiated Rate |
$163.50 |
| Rate for Payer: Aetna Commercial |
$77.81
|
| Rate for Payer: Aetna Medicare |
$109.00
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCN Commercial |
$88.64
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Mclaren Medicaid |
$32.38
|
| Rate for Payer: Meridian Medicaid |
$34.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.96
|
| Rate for Payer: UHC Medicaid |
$32.38
|
| Rate for Payer: UHCCP Medicaid |
$32.38
|
|
