|
PR PRCTECT PRTL W/MUCOSEC ILEOANAL ANAST RSVR
|
Professional
|
Both
|
$5,455.00
|
|
|
Service Code
|
HCPCS 45113
|
| Min. Negotiated Rate |
$1,769.06 |
| Max. Negotiated Rate |
$3,545.75 |
| Rate for Payer: Aetna Commercial |
$2,370.54
|
| Rate for Payer: Aetna Medicare |
$1,839.82
|
| Rate for Payer: BCBS Complete |
$2,182.00
|
| Rate for Payer: BCBS MAPPO |
$1,769.06
|
| Rate for Payer: BCN Medicare Advantage |
$1,769.06
|
| Rate for Payer: Cash Price |
$4,364.00
|
| Rate for Payer: Cash Price |
$4,364.00
|
| Rate for Payer: Cofinity Commercial |
$2,547.45
|
| Rate for Payer: Cofinity Commercial |
$2,370.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,769.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,857.51
|
| Rate for Payer: Nomi Health Commercial |
$2,122.87
|
| Rate for Payer: PACE SWMI |
$1,769.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,769.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,545.75
|
| Rate for Payer: Priority Health Medicare |
$1,786.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,769.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,769.06
|
| Rate for Payer: UHC Exchange |
$1,769.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,769.06
|
|
|
PR PRCTECT PRTL W/O ANAST PRNL APPR
|
Professional
|
Both
|
$3,047.00
|
|
|
Service Code
|
HCPCS 45123
|
| Min. Negotiated Rate |
$1,064.41 |
| Max. Negotiated Rate |
$1,980.55 |
| Rate for Payer: Aetna Commercial |
$1,426.31
|
| Rate for Payer: Aetna Medicare |
$1,106.99
|
| Rate for Payer: BCBS Complete |
$1,218.80
|
| Rate for Payer: BCBS MAPPO |
$1,064.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,064.41
|
| Rate for Payer: Cash Price |
$2,437.60
|
| Rate for Payer: Cash Price |
$2,437.60
|
| Rate for Payer: Cofinity Commercial |
$1,532.75
|
| Rate for Payer: Cofinity Commercial |
$1,426.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,064.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,117.63
|
| Rate for Payer: Nomi Health Commercial |
$1,277.29
|
| Rate for Payer: PACE SWMI |
$1,064.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,064.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,980.55
|
| Rate for Payer: Priority Health Medicare |
$1,075.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,064.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,064.41
|
| Rate for Payer: UHC Exchange |
$1,064.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,064.41
|
|
|
PR PREDNISONE IR OR DR ORAL 1MG
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
HCPCS J7512
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.65 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.01
|
| Rate for Payer: BCBS Complete |
$0.40
|
| Rate for Payer: BCBS MAPPO |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.01
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: PACE SWMI |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.65
|
| Rate for Payer: Priority Health Medicare |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.01
|
| Rate for Payer: UHC Medicare Advantage |
$0.01
|
|
|
PR PREDNISONE ORAL
|
Professional
|
Both
|
$1.00
|
|
|
Service Code
|
HCPCS J7506
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$0.65 |
| Rate for Payer: Aetna Medicare |
$0.50
|
| Rate for Payer: BCBS Complete |
$0.40
|
| Rate for Payer: Cash Price |
$0.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.65
|
|
|
PR PREPARE FECAL MICROBIOTA FOR INSTILLATION
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 44705
|
| Min. Negotiated Rate |
$81.60 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Aetna Medicare |
$102.00
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
|
|
PR PREPERITONEAL PEL PACK F/HEMRRG ASSOC PEL TRMA
|
Professional
|
Both
|
$942.00
|
|
|
Service Code
|
HCPCS 49013
|
| Min. Negotiated Rate |
$376.80 |
| Max. Negotiated Rate |
$638.55 |
| Rate for Payer: Aetna Commercial |
$594.21
|
| Rate for Payer: Aetna Medicare |
$461.18
|
| Rate for Payer: BCBS Complete |
$376.80
|
| Rate for Payer: BCBS MAPPO |
$443.44
|
| Rate for Payer: BCN Medicare Advantage |
$443.44
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cash Price |
$753.60
|
| Rate for Payer: Cofinity Commercial |
$594.21
|
| Rate for Payer: Cofinity Commercial |
$638.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$443.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$465.61
|
| Rate for Payer: Nomi Health Commercial |
$532.13
|
| Rate for Payer: PACE SWMI |
$443.44
|
| Rate for Payer: PHP Medicare Advantage |
$443.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$612.30
|
| Rate for Payer: Priority Health Medicare |
$447.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$443.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$443.44
|
| Rate for Payer: UHC Exchange |
$443.44
|
| Rate for Payer: UHC Medicare Advantage |
$443.44
|
|
|
PR PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT
|
Professional
|
Both
|
$670.00
|
|
|
Service Code
|
HCPCS 15004
|
| Min. Negotiated Rate |
$248.67 |
| Max. Negotiated Rate |
$435.50 |
| Rate for Payer: Aetna Commercial |
$333.22
|
| Rate for Payer: Aetna Medicare |
$258.62
|
| Rate for Payer: BCBS Complete |
$268.00
|
| Rate for Payer: BCBS MAPPO |
$248.67
|
| Rate for Payer: BCN Medicare Advantage |
$248.67
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cash Price |
$536.00
|
| Rate for Payer: Cofinity Commercial |
$358.08
|
| Rate for Payer: Cofinity Commercial |
$333.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.10
|
| Rate for Payer: Nomi Health Commercial |
$298.40
|
| Rate for Payer: PACE SWMI |
$248.67
|
| Rate for Payer: PHP Medicare Advantage |
$248.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.50
|
| Rate for Payer: Priority Health Medicare |
$251.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$248.67
|
| Rate for Payer: UHC Exchange |
$248.67
|
| Rate for Payer: UHC Medicare Advantage |
$248.67
|
|
|
PR PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 15005
|
| Min. Negotiated Rate |
$81.60 |
| Max. Negotiated Rate |
$132.60 |
| Rate for Payer: Aetna Commercial |
$115.86
|
| Rate for Payer: Aetna Medicare |
$89.92
|
| Rate for Payer: BCBS Complete |
$81.60
|
| Rate for Payer: BCBS MAPPO |
$86.46
|
| Rate for Payer: BCN Medicare Advantage |
$86.46
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$124.50
|
| Rate for Payer: Cofinity Commercial |
$115.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.78
|
| Rate for Payer: Nomi Health Commercial |
$103.75
|
| Rate for Payer: PACE SWMI |
$86.46
|
| Rate for Payer: PHP Medicare Advantage |
$86.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.60
|
| Rate for Payer: Priority Health Medicare |
$87.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.46
|
| Rate for Payer: UHC Exchange |
$86.46
|
| Rate for Payer: UHC Medicare Advantage |
$86.46
|
|
|
PR PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT
|
Professional
|
Both
|
$562.00
|
|
|
Service Code
|
HCPCS 15002
|
| Min. Negotiated Rate |
$210.50 |
| Max. Negotiated Rate |
$365.30 |
| Rate for Payer: Aetna Commercial |
$282.07
|
| Rate for Payer: Aetna Medicare |
$218.92
|
| Rate for Payer: BCBS Complete |
$224.80
|
| Rate for Payer: BCBS MAPPO |
$210.50
|
| Rate for Payer: BCN Medicare Advantage |
$210.50
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cofinity Commercial |
$303.12
|
| Rate for Payer: Cofinity Commercial |
$282.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$221.03
|
| Rate for Payer: Nomi Health Commercial |
$252.60
|
| Rate for Payer: PACE SWMI |
$210.50
|
| Rate for Payer: PHP Medicare Advantage |
$210.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.30
|
| Rate for Payer: Priority Health Medicare |
$212.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.50
|
| Rate for Payer: UHC Exchange |
$210.50
|
| Rate for Payer: UHC Medicare Advantage |
$210.50
|
|
|
PR PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 15003
|
| Min. Negotiated Rate |
$42.94 |
| Max. Negotiated Rate |
$83.20 |
| Rate for Payer: Aetna Commercial |
$57.54
|
| Rate for Payer: Aetna Medicare |
$44.66
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS MAPPO |
$42.94
|
| Rate for Payer: BCN Medicare Advantage |
$42.94
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$61.83
|
| Rate for Payer: Cofinity Commercial |
$57.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.09
|
| Rate for Payer: Nomi Health Commercial |
$51.53
|
| Rate for Payer: PACE SWMI |
$42.94
|
| Rate for Payer: PHP Medicare Advantage |
$42.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health Medicare |
$43.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.94
|
| Rate for Payer: UHC Exchange |
$42.94
|
| Rate for Payer: UHC Medicare Advantage |
$42.94
|
|
|
PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 94640
|
| Min. Negotiated Rate |
$7.16 |
| Max. Negotiated Rate |
$24.70 |
| Rate for Payer: Aetna Commercial |
$9.59
|
| Rate for Payer: Aetna Medicare |
$7.45
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$7.16
|
| Rate for Payer: BCN Medicare Advantage |
$7.16
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cofinity Commercial |
$9.59
|
| Rate for Payer: Cofinity Commercial |
$10.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.52
|
| Rate for Payer: Nomi Health Commercial |
$8.59
|
| Rate for Payer: PACE SWMI |
$7.16
|
| Rate for Payer: PHP Medicare Advantage |
$7.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
| Rate for Payer: Priority Health Medicare |
$7.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.16
|
| Rate for Payer: UHC Exchange |
$7.16
|
| Rate for Payer: UHC Medicare Advantage |
$7.16
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 15 MIN
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 99401
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$42.90 |
| Rate for Payer: Aetna Medicare |
$33.00
|
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 30 MIN
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 99402
|
| Min. Negotiated Rate |
$45.60 |
| Max. Negotiated Rate |
$74.10 |
| Rate for Payer: Aetna Medicare |
$57.00
|
| Rate for Payer: BCBS Complete |
$45.60
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.10
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 45 MIN
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 99403
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$95.55 |
| Rate for Payer: Aetna Medicare |
$73.50
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.55
|
|
|
PR PREV MED CNSL&/RSK FCTR RDCTJ INDV APPROX 60 MIN
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 99404
|
| Min. Negotiated Rate |
$75.20 |
| Max. Negotiated Rate |
$122.20 |
| Rate for Payer: Aetna Medicare |
$94.00
|
| Rate for Payer: BCBS Complete |
$75.20
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
|
|
PR PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 99412
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$21.45 |
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
|
|
PR PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 93279
|
| Min. Negotiated Rate |
$60.77 |
| Max. Negotiated Rate |
$109.20 |
| Rate for Payer: Aetna Commercial |
$81.43
|
| Rate for Payer: Aetna Medicare |
$63.20
|
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: BCBS MAPPO |
$60.77
|
| Rate for Payer: BCN Medicare Advantage |
$60.77
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$87.51
|
| Rate for Payer: Cofinity Commercial |
$81.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.81
|
| Rate for Payer: Nomi Health Commercial |
$72.92
|
| Rate for Payer: PACE SWMI |
$60.77
|
| Rate for Payer: PHP Medicare Advantage |
$60.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
| Rate for Payer: Priority Health Medicare |
$61.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.77
|
| Rate for Payer: UHC Exchange |
$60.77
|
| Rate for Payer: UHC Medicare Advantage |
$60.77
|
|
|
PR PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 93285
|
| Min. Negotiated Rate |
$48.80 |
| Max. Negotiated Rate |
$79.30 |
| Rate for Payer: Aetna Commercial |
$71.84
|
| Rate for Payer: Aetna Commercial |
$71.84
|
| Rate for Payer: Aetna Medicare |
$55.75
|
| Rate for Payer: Aetna Medicare |
$55.75
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS Complete |
$34.80
|
| Rate for Payer: BCBS MAPPO |
$53.61
|
| Rate for Payer: BCBS MAPPO |
$53.61
|
| Rate for Payer: BCN Medicare Advantage |
$53.61
|
| Rate for Payer: BCN Medicare Advantage |
$53.61
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$77.20
|
| Rate for Payer: Cofinity Commercial |
$71.84
|
| Rate for Payer: Cofinity Commercial |
$77.20
|
| Rate for Payer: Cofinity Commercial |
$71.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.29
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: PACE SWMI |
$53.61
|
| Rate for Payer: PACE SWMI |
$53.61
|
| Rate for Payer: PHP Medicare Advantage |
$53.61
|
| Rate for Payer: PHP Medicare Advantage |
$53.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.55
|
| Rate for Payer: Priority Health Medicare |
$54.15
|
| Rate for Payer: Priority Health Medicare |
$54.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.61
|
| Rate for Payer: UHC Exchange |
$53.61
|
| Rate for Payer: UHC Exchange |
$53.61
|
| Rate for Payer: UHC Medicare Advantage |
$53.61
|
| Rate for Payer: UHC Medicare Advantage |
$53.61
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB
|
Professional
|
Both
|
$170.00
|
|
|
Service Code
|
HCPCS 93284
|
| Min. Negotiated Rate |
$68.00 |
| Max. Negotiated Rate |
$138.18 |
| Rate for Payer: Aetna Commercial |
$128.59
|
| Rate for Payer: Aetna Medicare |
$99.80
|
| Rate for Payer: BCBS Complete |
$68.00
|
| Rate for Payer: BCBS MAPPO |
$95.96
|
| Rate for Payer: BCN Medicare Advantage |
$95.96
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cash Price |
$136.00
|
| Rate for Payer: Cofinity Commercial |
$138.18
|
| Rate for Payer: Cofinity Commercial |
$128.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.76
|
| Rate for Payer: Nomi Health Commercial |
$115.15
|
| Rate for Payer: PACE SWMI |
$95.96
|
| Rate for Payer: PHP Medicare Advantage |
$95.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.50
|
| Rate for Payer: Priority Health Medicare |
$96.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.96
|
| Rate for Payer: UHC Exchange |
$95.96
|
| Rate for Payer: UHC Medicare Advantage |
$95.96
|
|
|
PR PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 93283
|
| Min. Negotiated Rate |
$63.20 |
| Max. Negotiated Rate |
$128.02 |
| Rate for Payer: Aetna Commercial |
$119.13
|
| Rate for Payer: Aetna Medicare |
$92.46
|
| Rate for Payer: BCBS Complete |
$63.20
|
| Rate for Payer: BCBS MAPPO |
$88.90
|
| Rate for Payer: BCN Medicare Advantage |
$88.90
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$128.02
|
| Rate for Payer: Cofinity Commercial |
$119.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.34
|
| Rate for Payer: Nomi Health Commercial |
$106.68
|
| Rate for Payer: PACE SWMI |
$88.90
|
| Rate for Payer: PHP Medicare Advantage |
$88.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.70
|
| Rate for Payer: Priority Health Medicare |
$89.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.90
|
| Rate for Payer: UHC Exchange |
$88.90
|
| Rate for Payer: UHC Medicare Advantage |
$88.90
|
|
|
PR PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 93282
|
| Min. Negotiated Rate |
$49.60 |
| Max. Negotiated Rate |
$103.74 |
| Rate for Payer: Aetna Commercial |
$96.53
|
| Rate for Payer: Aetna Medicare |
$74.92
|
| Rate for Payer: BCBS Complete |
$49.60
|
| Rate for Payer: BCBS MAPPO |
$72.04
|
| Rate for Payer: BCN Medicare Advantage |
$72.04
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$96.53
|
| Rate for Payer: Cofinity Commercial |
$103.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.64
|
| Rate for Payer: Nomi Health Commercial |
$86.45
|
| Rate for Payer: PACE SWMI |
$72.04
|
| Rate for Payer: PHP Medicare Advantage |
$72.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.60
|
| Rate for Payer: Priority Health Medicare |
$72.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$72.04
|
| Rate for Payer: UHC Exchange |
$72.04
|
| Rate for Payer: UHC Medicare Advantage |
$72.04
|
|
|
PR PRICARDIECTOMY STOT/COMPL W/CARDPULM BYPASS
|
Professional
|
Both
|
$5,726.00
|
|
|
Service Code
|
HCPCS 33031
|
| Min. Negotiated Rate |
$2,290.40 |
| Max. Negotiated Rate |
$3,721.90 |
| Rate for Payer: Aetna Commercial |
$3,177.30
|
| Rate for Payer: Aetna Medicare |
$2,465.96
|
| Rate for Payer: BCBS Complete |
$2,290.40
|
| Rate for Payer: BCBS MAPPO |
$2,371.12
|
| Rate for Payer: BCN Medicare Advantage |
$2,371.12
|
| Rate for Payer: Cash Price |
$4,580.80
|
| Rate for Payer: Cash Price |
$4,580.80
|
| Rate for Payer: Cofinity Commercial |
$3,414.41
|
| Rate for Payer: Cofinity Commercial |
$3,177.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,371.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,489.68
|
| Rate for Payer: Nomi Health Commercial |
$2,845.34
|
| Rate for Payer: PACE SWMI |
$2,371.12
|
| Rate for Payer: PHP Medicare Advantage |
$2,371.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,721.90
|
| Rate for Payer: Priority Health Medicare |
$2,394.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,371.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,371.12
|
| Rate for Payer: UHC Exchange |
$2,371.12
|
| Rate for Payer: UHC Medicare Advantage |
$2,371.12
|
|
|
PR PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS
|
Professional
|
Both
|
$3,419.00
|
|
|
Service Code
|
HCPCS 33030
|
| Min. Negotiated Rate |
$1,367.60 |
| Max. Negotiated Rate |
$2,764.37 |
| Rate for Payer: Aetna Commercial |
$2,572.40
|
| Rate for Payer: Aetna Medicare |
$1,996.49
|
| Rate for Payer: BCBS Complete |
$1,367.60
|
| Rate for Payer: BCBS MAPPO |
$1,919.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,919.70
|
| Rate for Payer: Cash Price |
$2,735.20
|
| Rate for Payer: Cash Price |
$2,735.20
|
| Rate for Payer: Cofinity Commercial |
$2,764.37
|
| Rate for Payer: Cofinity Commercial |
$2,572.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,919.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,015.68
|
| Rate for Payer: Nomi Health Commercial |
$2,303.64
|
| Rate for Payer: PACE SWMI |
$1,919.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,919.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,222.35
|
| Rate for Payer: Priority Health Medicare |
$1,938.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,919.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,919.70
|
| Rate for Payer: UHC Exchange |
$1,919.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,919.70
|
|
|
PR PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST
|
Professional
|
Both
|
$4,133.00
|
|
|
Service Code
|
HCPCS 37184
|
| Min. Negotiated Rate |
$408.97 |
| Max. Negotiated Rate |
$2,686.45 |
| Rate for Payer: Aetna Commercial |
$548.02
|
| Rate for Payer: Aetna Medicare |
$425.33
|
| Rate for Payer: BCBS Complete |
$1,653.20
|
| Rate for Payer: BCBS MAPPO |
$408.97
|
| Rate for Payer: BCN Medicare Advantage |
$408.97
|
| Rate for Payer: Cash Price |
$3,306.40
|
| Rate for Payer: Cash Price |
$3,306.40
|
| Rate for Payer: Cofinity Commercial |
$588.92
|
| Rate for Payer: Cofinity Commercial |
$548.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$408.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$429.42
|
| Rate for Payer: Nomi Health Commercial |
$490.76
|
| Rate for Payer: PACE SWMI |
$408.97
|
| Rate for Payer: PHP Medicare Advantage |
$408.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,686.45
|
| Rate for Payer: Priority Health Medicare |
$413.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$408.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$408.97
|
| Rate for Payer: UHC Exchange |
$408.97
|
| Rate for Payer: UHC Medicare Advantage |
$408.97
|
|
|
PR PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ
|
Professional
|
Both
|
$3,440.00
|
|
|
Service Code
|
HCPCS 37185
|
| Min. Negotiated Rate |
$154.79 |
| Max. Negotiated Rate |
$2,236.00 |
| Rate for Payer: Aetna Commercial |
$207.42
|
| Rate for Payer: Aetna Medicare |
$160.98
|
| Rate for Payer: BCBS Complete |
$1,376.00
|
| Rate for Payer: BCBS MAPPO |
$154.79
|
| Rate for Payer: BCN Medicare Advantage |
$154.79
|
| Rate for Payer: Cash Price |
$2,752.00
|
| Rate for Payer: Cash Price |
$2,752.00
|
| Rate for Payer: Cofinity Commercial |
$222.90
|
| Rate for Payer: Cofinity Commercial |
$207.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.53
|
| Rate for Payer: Nomi Health Commercial |
$185.75
|
| Rate for Payer: PACE SWMI |
$154.79
|
| Rate for Payer: PHP Medicare Advantage |
$154.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,236.00
|
| Rate for Payer: Priority Health Medicare |
$156.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.79
|
| Rate for Payer: UHC Exchange |
$154.79
|
| Rate for Payer: UHC Medicare Advantage |
$154.79
|
|
