|
PR RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE
|
Professional
|
Both
|
$1,043.00
|
|
|
Service Code
|
HCPCS 26593
|
| Min. Negotiated Rate |
$417.20 |
| Max. Negotiated Rate |
$864.95 |
| Rate for Payer: Aetna Commercial |
$804.88
|
| Rate for Payer: Aetna Medicare |
$624.69
|
| Rate for Payer: BCBS Complete |
$417.20
|
| Rate for Payer: BCBS MAPPO |
$600.66
|
| Rate for Payer: BCN Medicare Advantage |
$600.66
|
| Rate for Payer: Cash Price |
$834.40
|
| Rate for Payer: Cash Price |
$834.40
|
| Rate for Payer: Cofinity Commercial |
$864.95
|
| Rate for Payer: Cofinity Commercial |
$804.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$600.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$630.69
|
| Rate for Payer: Nomi Health Commercial |
$720.79
|
| Rate for Payer: PACE SWMI |
$600.66
|
| Rate for Payer: PHP Medicare Advantage |
$600.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$677.95
|
| Rate for Payer: Priority Health Medicare |
$606.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$600.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$600.66
|
| Rate for Payer: UHC Exchange |
$600.66
|
| Rate for Payer: UHC Medicare Advantage |
$600.66
|
|
|
PR RELEASE/RECESSION HAMSTRING PROXIMAL
|
Professional
|
Both
|
$2,326.00
|
|
|
Service Code
|
HCPCS 27097
|
| Min. Negotiated Rate |
$661.61 |
| Max. Negotiated Rate |
$1,511.90 |
| Rate for Payer: Aetna Commercial |
$886.56
|
| Rate for Payer: Aetna Medicare |
$688.07
|
| Rate for Payer: BCBS Complete |
$930.40
|
| Rate for Payer: BCBS MAPPO |
$661.61
|
| Rate for Payer: BCN Medicare Advantage |
$661.61
|
| Rate for Payer: Cash Price |
$1,860.80
|
| Rate for Payer: Cash Price |
$1,860.80
|
| Rate for Payer: Cofinity Commercial |
$952.72
|
| Rate for Payer: Cofinity Commercial |
$886.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$661.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$694.69
|
| Rate for Payer: Nomi Health Commercial |
$793.93
|
| Rate for Payer: PACE SWMI |
$661.61
|
| Rate for Payer: PHP Medicare Advantage |
$661.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,511.90
|
| Rate for Payer: Priority Health Medicare |
$668.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$661.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$661.61
|
| Rate for Payer: UHC Exchange |
$661.61
|
| Rate for Payer: UHC Medicare Advantage |
$661.61
|
|
|
PR RELEASE TARSAL TUNNEL
|
Professional
|
Both
|
$1,384.00
|
|
|
Service Code
|
HCPCS 28035
|
| Min. Negotiated Rate |
$347.15 |
| Max. Negotiated Rate |
$899.60 |
| Rate for Payer: Aetna Commercial |
$465.18
|
| Rate for Payer: Aetna Medicare |
$361.04
|
| Rate for Payer: BCBS Complete |
$553.60
|
| Rate for Payer: BCBS MAPPO |
$347.15
|
| Rate for Payer: BCN Medicare Advantage |
$347.15
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cash Price |
$1,107.20
|
| Rate for Payer: Cofinity Commercial |
$499.90
|
| Rate for Payer: Cofinity Commercial |
$465.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$364.51
|
| Rate for Payer: Nomi Health Commercial |
$416.58
|
| Rate for Payer: PACE SWMI |
$347.15
|
| Rate for Payer: PHP Medicare Advantage |
$347.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.60
|
| Rate for Payer: Priority Health Medicare |
$350.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$347.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$347.15
|
| Rate for Payer: UHC Exchange |
$347.15
|
| Rate for Payer: UHC Medicare Advantage |
$347.15
|
|
|
PR RELEASE THENAR MUSCLE
|
Professional
|
Both
|
$1,586.00
|
|
|
Service Code
|
HCPCS 26508
|
| Min. Negotiated Rate |
$629.51 |
| Max. Negotiated Rate |
$1,030.90 |
| Rate for Payer: Aetna Commercial |
$843.54
|
| Rate for Payer: Aetna Medicare |
$654.69
|
| Rate for Payer: BCBS Complete |
$634.40
|
| Rate for Payer: BCBS MAPPO |
$629.51
|
| Rate for Payer: BCN Medicare Advantage |
$629.51
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cash Price |
$1,268.80
|
| Rate for Payer: Cofinity Commercial |
$906.49
|
| Rate for Payer: Cofinity Commercial |
$843.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$629.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$660.99
|
| Rate for Payer: Nomi Health Commercial |
$755.41
|
| Rate for Payer: PACE SWMI |
$629.51
|
| Rate for Payer: PHP Medicare Advantage |
$629.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,030.90
|
| Rate for Payer: Priority Health Medicare |
$635.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$629.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$629.51
|
| Rate for Payer: UHC Exchange |
$629.51
|
| Rate for Payer: UHC Medicare Advantage |
$629.51
|
|
|
PR RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR
|
Professional
|
Both
|
$1,357.00
|
|
|
Service Code
|
HCPCS 33223
|
| Min. Negotiated Rate |
$387.40 |
| Max. Negotiated Rate |
$882.05 |
| Rate for Payer: Aetna Commercial |
$519.12
|
| Rate for Payer: Aetna Medicare |
$402.90
|
| Rate for Payer: BCBS Complete |
$542.80
|
| Rate for Payer: BCBS MAPPO |
$387.40
|
| Rate for Payer: BCN Medicare Advantage |
$387.40
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cofinity Commercial |
$557.86
|
| Rate for Payer: Cofinity Commercial |
$519.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$387.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$406.77
|
| Rate for Payer: Nomi Health Commercial |
$464.88
|
| Rate for Payer: PACE SWMI |
$387.40
|
| Rate for Payer: PHP Medicare Advantage |
$387.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$882.05
|
| Rate for Payer: Priority Health Medicare |
$391.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$387.40
|
| Rate for Payer: UHC Exchange |
$387.40
|
| Rate for Payer: UHC Medicare Advantage |
$387.40
|
|
|
PR RELOCATION OF SKIN POCKET FOR PACEMAKER
|
Professional
|
Both
|
$1,151.00
|
|
|
Service Code
|
HCPCS 33222
|
| Min. Negotiated Rate |
$324.53 |
| Max. Negotiated Rate |
$748.15 |
| Rate for Payer: Aetna Commercial |
$434.87
|
| Rate for Payer: Aetna Medicare |
$337.51
|
| Rate for Payer: BCBS Complete |
$460.40
|
| Rate for Payer: BCBS MAPPO |
$324.53
|
| Rate for Payer: BCN Medicare Advantage |
$324.53
|
| Rate for Payer: Cash Price |
$920.80
|
| Rate for Payer: Cash Price |
$920.80
|
| Rate for Payer: Cofinity Commercial |
$467.32
|
| Rate for Payer: Cofinity Commercial |
$434.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$340.76
|
| Rate for Payer: Nomi Health Commercial |
$389.44
|
| Rate for Payer: PACE SWMI |
$324.53
|
| Rate for Payer: PHP Medicare Advantage |
$324.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$748.15
|
| Rate for Payer: Priority Health Medicare |
$327.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.53
|
| Rate for Payer: UHC Exchange |
$324.53
|
| Rate for Payer: UHC Medicare Advantage |
$324.53
|
|
|
PR REM INTERROG ICPMS <30 D PHYS/QHP
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 93297
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$78.90 |
| Rate for Payer: Aetna Commercial |
$73.42
|
| Rate for Payer: Aetna Medicare |
$56.98
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS MAPPO |
$54.79
|
| Rate for Payer: BCN Medicare Advantage |
$54.79
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$78.90
|
| Rate for Payer: Cofinity Commercial |
$73.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.53
|
| Rate for Payer: Nomi Health Commercial |
$65.75
|
| Rate for Payer: PACE SWMI |
$54.79
|
| Rate for Payer: PHP Medicare Advantage |
$54.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health Medicare |
$55.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.79
|
| Rate for Payer: UHC Exchange |
$54.79
|
| Rate for Payer: UHC Medicare Advantage |
$54.79
|
|
|
PR REM INTERROG ICPMS/SCRMS <30 D TECH REVIEW
|
Professional
|
Both
|
$232.00
|
|
|
Service Code
|
HCPCS 93299
|
| Min. Negotiated Rate |
$92.80 |
| Max. Negotiated Rate |
$150.80 |
| Rate for Payer: Aetna Medicare |
$116.00
|
| Rate for Payer: BCBS Complete |
$92.80
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.80
|
|
|
PR REM INTERROG PM/LDLS PM <90 D PHYS/QHP
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 93294
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$40.30 |
| Rate for Payer: Aetna Commercial |
$37.12
|
| Rate for Payer: Aetna Medicare |
$28.81
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: BCBS MAPPO |
$27.70
|
| Rate for Payer: BCN Medicare Advantage |
$27.70
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$39.89
|
| Rate for Payer: Cofinity Commercial |
$37.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.09
|
| Rate for Payer: Nomi Health Commercial |
$33.24
|
| Rate for Payer: PACE SWMI |
$27.70
|
| Rate for Payer: PHP Medicare Advantage |
$27.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health Medicare |
$27.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.70
|
| Rate for Payer: UHC Exchange |
$27.70
|
| Rate for Payer: UHC Medicare Advantage |
$27.70
|
|
|
PR REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 93296
|
| Min. Negotiated Rate |
$17.77 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Commercial |
$23.81
|
| Rate for Payer: Aetna Medicare |
$18.48
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS MAPPO |
$17.77
|
| Rate for Payer: BCN Medicare Advantage |
$17.77
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$25.59
|
| Rate for Payer: Cofinity Commercial |
$23.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.66
|
| Rate for Payer: Nomi Health Commercial |
$21.32
|
| Rate for Payer: PACE SWMI |
$17.77
|
| Rate for Payer: PHP Medicare Advantage |
$17.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Medicare |
$17.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.77
|
| Rate for Payer: UHC Exchange |
$17.77
|
| Rate for Payer: UHC Medicare Advantage |
$17.77
|
|
|
PR REM INTERROG SCRMS <30 D PHYS/QHP
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 93298
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$130.80 |
| Rate for Payer: Aetna Commercial |
$121.71
|
| Rate for Payer: Aetna Medicare |
$94.46
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: BCBS MAPPO |
$90.83
|
| Rate for Payer: BCN Medicare Advantage |
$90.83
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$130.80
|
| Rate for Payer: Cofinity Commercial |
$121.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$109.00
|
| Rate for Payer: PACE SWMI |
$90.83
|
| Rate for Payer: PHP Medicare Advantage |
$90.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.75
|
| Rate for Payer: Priority Health Medicare |
$91.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.83
|
| Rate for Payer: UHC Exchange |
$90.83
|
| Rate for Payer: UHC Medicare Advantage |
$90.83
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
HCPCS 99454
|
| Min. Negotiated Rate |
$39.28 |
| Max. Negotiated Rate |
$72.15 |
| Rate for Payer: Aetna Commercial |
$52.64
|
| Rate for Payer: Aetna Medicare |
$40.85
|
| Rate for Payer: BCBS Complete |
$44.40
|
| Rate for Payer: BCBS MAPPO |
$39.28
|
| Rate for Payer: BCN Medicare Advantage |
$39.28
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cofinity Commercial |
$56.56
|
| Rate for Payer: Cofinity Commercial |
$52.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.24
|
| Rate for Payer: Nomi Health Commercial |
$47.14
|
| Rate for Payer: PACE SWMI |
$39.28
|
| Rate for Payer: PHP Medicare Advantage |
$39.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.15
|
| Rate for Payer: Priority Health Medicare |
$39.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.28
|
| Rate for Payer: UHC Exchange |
$39.28
|
| Rate for Payer: UHC Medicare Advantage |
$39.28
|
|
|
PR REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 99453
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$26.12 |
| Rate for Payer: Aetna Commercial |
$24.31
|
| Rate for Payer: Aetna Medicare |
$18.87
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$18.14
|
| Rate for Payer: BCN Medicare Advantage |
$18.14
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$26.12
|
| Rate for Payer: Cofinity Commercial |
$24.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.05
|
| Rate for Payer: Nomi Health Commercial |
$21.77
|
| Rate for Payer: PACE SWMI |
$18.14
|
| Rate for Payer: PHP Medicare Advantage |
$18.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Medicare |
$18.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.14
|
| Rate for Payer: UHC Exchange |
$18.14
|
| Rate for Payer: UHC Medicare Advantage |
$18.14
|
|
|
PR REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D
|
Professional
|
Both
|
$101.00
|
|
|
Service Code
|
HCPCS 93264
|
| Min. Negotiated Rate |
$33.55 |
| Max. Negotiated Rate |
$65.65 |
| Rate for Payer: Aetna Commercial |
$44.96
|
| Rate for Payer: Aetna Medicare |
$34.89
|
| Rate for Payer: BCBS Complete |
$40.40
|
| Rate for Payer: BCBS MAPPO |
$33.55
|
| Rate for Payer: BCN Medicare Advantage |
$33.55
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$48.31
|
| Rate for Payer: Cofinity Commercial |
$44.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.23
|
| Rate for Payer: Nomi Health Commercial |
$40.26
|
| Rate for Payer: PACE SWMI |
$33.55
|
| Rate for Payer: PHP Medicare Advantage |
$33.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.65
|
| Rate for Payer: Priority Health Medicare |
$33.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.55
|
| Rate for Payer: UHC Exchange |
$33.55
|
| Rate for Payer: UHC Medicare Advantage |
$33.55
|
|
|
PR REMOTE PHYSIOLOGIC MONITORING 1ST 20 MIN MONTH
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 99457
|
| Min. Negotiated Rate |
$28.32 |
| Max. Negotiated Rate |
$65.00 |
| Rate for Payer: Aetna Commercial |
$37.95
|
| Rate for Payer: Aetna Medicare |
$29.45
|
| Rate for Payer: BCBS Complete |
$40.00
|
| Rate for Payer: BCBS MAPPO |
$28.32
|
| Rate for Payer: BCN Medicare Advantage |
$28.32
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$37.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.74
|
| Rate for Payer: Nomi Health Commercial |
$33.98
|
| Rate for Payer: PACE SWMI |
$28.32
|
| Rate for Payer: PHP Medicare Advantage |
$28.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.00
|
| Rate for Payer: Priority Health Medicare |
$28.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.32
|
| Rate for Payer: UHC Exchange |
$28.32
|
| Rate for Payer: UHC Medicare Advantage |
$28.32
|
|
|
PR REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 99458
|
| Min. Negotiated Rate |
$28.32 |
| Max. Negotiated Rate |
$53.30 |
| Rate for Payer: Aetna Commercial |
$37.95
|
| Rate for Payer: Aetna Medicare |
$29.45
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS MAPPO |
$28.32
|
| Rate for Payer: BCN Medicare Advantage |
$28.32
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$37.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.74
|
| Rate for Payer: Nomi Health Commercial |
$33.98
|
| Rate for Payer: PACE SWMI |
$28.32
|
| Rate for Payer: PHP Medicare Advantage |
$28.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health Medicare |
$28.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.32
|
| Rate for Payer: UHC Exchange |
$28.32
|
| Rate for Payer: UHC Medicare Advantage |
$28.32
|
|
|
PR REMOT IMAGE SUBMIT BY PT
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS G2010
|
| Min. Negotiated Rate |
$8.56 |
| Max. Negotiated Rate |
$15.60 |
| Rate for Payer: Aetna Commercial |
$11.47
|
| Rate for Payer: Aetna Medicare |
$8.90
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$8.56
|
| Rate for Payer: BCN Medicare Advantage |
$8.56
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$12.33
|
| Rate for Payer: Cofinity Commercial |
$11.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.99
|
| Rate for Payer: Nomi Health Commercial |
$10.27
|
| Rate for Payer: PACE SWMI |
$8.56
|
| Rate for Payer: PHP Medicare Advantage |
$8.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: Priority Health Medicare |
$8.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.56
|
| Rate for Payer: UHC Exchange |
$8.56
|
| Rate for Payer: UHC Medicare Advantage |
$8.56
|
|
|
PR REMOVAL ANAL SETON OTHER MARKER
|
Professional
|
Both
|
$241.00
|
|
|
Service Code
|
HCPCS 46030
|
| Min. Negotiated Rate |
$83.50 |
| Max. Negotiated Rate |
$156.65 |
| Rate for Payer: Aetna Commercial |
$111.89
|
| Rate for Payer: Aetna Medicare |
$86.84
|
| Rate for Payer: BCBS Complete |
$96.40
|
| Rate for Payer: BCBS MAPPO |
$83.50
|
| Rate for Payer: BCN Medicare Advantage |
$83.50
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Cofinity Commercial |
$120.24
|
| Rate for Payer: Cofinity Commercial |
$111.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.67
|
| Rate for Payer: Nomi Health Commercial |
$100.20
|
| Rate for Payer: PACE SWMI |
$83.50
|
| Rate for Payer: PHP Medicare Advantage |
$83.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.65
|
| Rate for Payer: Priority Health Medicare |
$84.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.50
|
| Rate for Payer: UHC Exchange |
$83.50
|
| Rate for Payer: UHC Medicare Advantage |
$83.50
|
|
|
PR REMOVAL ANKLE IMPLANT
|
Professional
|
Both
|
$1,822.00
|
|
|
Service Code
|
HCPCS 27704
|
| Min. Negotiated Rate |
$543.42 |
| Max. Negotiated Rate |
$1,184.30 |
| Rate for Payer: Aetna Commercial |
$728.18
|
| Rate for Payer: Aetna Medicare |
$565.16
|
| Rate for Payer: BCBS Complete |
$728.80
|
| Rate for Payer: BCBS MAPPO |
$543.42
|
| Rate for Payer: BCN Medicare Advantage |
$543.42
|
| Rate for Payer: Cash Price |
$1,457.60
|
| Rate for Payer: Cash Price |
$1,457.60
|
| Rate for Payer: Cofinity Commercial |
$782.52
|
| Rate for Payer: Cofinity Commercial |
$728.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$543.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$570.59
|
| Rate for Payer: Nomi Health Commercial |
$652.10
|
| Rate for Payer: PACE SWMI |
$543.42
|
| Rate for Payer: PHP Medicare Advantage |
$543.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,184.30
|
| Rate for Payer: Priority Health Medicare |
$548.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$543.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$543.42
|
| Rate for Payer: UHC Exchange |
$543.42
|
| Rate for Payer: UHC Medicare Advantage |
$543.42
|
|
|
PR REMOVAL ANTERIOR INSTRUMENTATION
|
Professional
|
Both
|
$4,043.00
|
|
|
Service Code
|
HCPCS 22855
|
| Min. Negotiated Rate |
$1,083.15 |
| Max. Negotiated Rate |
$2,627.95 |
| Rate for Payer: Aetna Commercial |
$1,451.42
|
| Rate for Payer: Aetna Medicare |
$1,126.48
|
| Rate for Payer: BCBS Complete |
$1,617.20
|
| Rate for Payer: BCBS MAPPO |
$1,083.15
|
| Rate for Payer: BCN Medicare Advantage |
$1,083.15
|
| Rate for Payer: Cash Price |
$3,234.40
|
| Rate for Payer: Cash Price |
$3,234.40
|
| Rate for Payer: Cofinity Commercial |
$1,559.74
|
| Rate for Payer: Cofinity Commercial |
$1,451.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,083.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,137.31
|
| Rate for Payer: Nomi Health Commercial |
$1,299.78
|
| Rate for Payer: PACE SWMI |
$1,083.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,083.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,627.95
|
| Rate for Payer: Priority Health Medicare |
$1,093.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,083.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,083.15
|
| Rate for Payer: UHC Exchange |
$1,083.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,083.15
|
|
|
PR REMOVAL/BIVALVING FULL ARM/FULL LEG CAST
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 29705
|
| Min. Negotiated Rate |
$43.37 |
| Max. Negotiated Rate |
$76.05 |
| Rate for Payer: Aetna Commercial |
$58.12
|
| Rate for Payer: Aetna Medicare |
$45.10
|
| Rate for Payer: BCBS Complete |
$46.80
|
| Rate for Payer: BCBS MAPPO |
$43.37
|
| Rate for Payer: BCN Medicare Advantage |
$43.37
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$62.45
|
| Rate for Payer: Cofinity Commercial |
$58.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.54
|
| Rate for Payer: Nomi Health Commercial |
$52.04
|
| Rate for Payer: PACE SWMI |
$43.37
|
| Rate for Payer: PHP Medicare Advantage |
$43.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health Medicare |
$43.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.37
|
| Rate for Payer: UHC Exchange |
$43.37
|
| Rate for Payer: UHC Medicare Advantage |
$43.37
|
|
|
PR REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA
|
Professional
|
Both
|
$370.00
|
|
|
Service Code
|
HCPCS 59871
|
| Min. Negotiated Rate |
$129.72 |
| Max. Negotiated Rate |
$240.50 |
| Rate for Payer: Aetna Commercial |
$173.82
|
| Rate for Payer: Aetna Medicare |
$134.91
|
| Rate for Payer: BCBS Complete |
$148.00
|
| Rate for Payer: BCBS MAPPO |
$129.72
|
| Rate for Payer: BCN Medicare Advantage |
$129.72
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cofinity Commercial |
$186.80
|
| Rate for Payer: Cofinity Commercial |
$173.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$136.21
|
| Rate for Payer: Nomi Health Commercial |
$155.66
|
| Rate for Payer: PACE SWMI |
$129.72
|
| Rate for Payer: PHP Medicare Advantage |
$129.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.50
|
| Rate for Payer: Priority Health Medicare |
$131.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.72
|
| Rate for Payer: UHC Exchange |
$129.72
|
| Rate for Payer: UHC Medicare Advantage |
$129.72
|
|
|
PR REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE
|
Professional
|
Both
|
$1,549.00
|
|
|
Service Code
|
HCPCS 21029
|
| Min. Negotiated Rate |
$598.30 |
| Max. Negotiated Rate |
$1,006.85 |
| Rate for Payer: Aetna Commercial |
$801.72
|
| Rate for Payer: Aetna Medicare |
$622.23
|
| Rate for Payer: BCBS Complete |
$619.60
|
| Rate for Payer: BCBS MAPPO |
$598.30
|
| Rate for Payer: BCN Medicare Advantage |
$598.30
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cofinity Commercial |
$861.55
|
| Rate for Payer: Cofinity Commercial |
$801.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$598.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$628.22
|
| Rate for Payer: Nomi Health Commercial |
$717.96
|
| Rate for Payer: PACE SWMI |
$598.30
|
| Rate for Payer: PHP Medicare Advantage |
$598.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.85
|
| Rate for Payer: Priority Health Medicare |
$604.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$598.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$598.30
|
| Rate for Payer: UHC Exchange |
$598.30
|
| Rate for Payer: UHC Medicare Advantage |
$598.30
|
|
|
PR REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATO
|
Professional
|
Both
|
$1,541.00
|
|
|
Service Code
|
HCPCS 64570
|
| Min. Negotiated Rate |
$616.40 |
| Max. Negotiated Rate |
$1,049.57 |
| Rate for Payer: Aetna Commercial |
$976.69
|
| Rate for Payer: Aetna Medicare |
$758.02
|
| Rate for Payer: BCBS Complete |
$616.40
|
| Rate for Payer: BCBS MAPPO |
$728.87
|
| Rate for Payer: BCN Medicare Advantage |
$728.87
|
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Cash Price |
$1,232.80
|
| Rate for Payer: Cofinity Commercial |
$976.69
|
| Rate for Payer: Cofinity Commercial |
$1,049.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$765.31
|
| Rate for Payer: Nomi Health Commercial |
$874.64
|
| Rate for Payer: PACE SWMI |
$728.87
|
| Rate for Payer: PHP Medicare Advantage |
$728.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,001.65
|
| Rate for Payer: Priority Health Medicare |
$736.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$728.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$728.87
|
| Rate for Payer: UHC Exchange |
$728.87
|
| Rate for Payer: UHC Medicare Advantage |
$728.87
|
|
|
PR REMOVAL EMBEDDED FOREIGN BODY EYELID
|
Professional
|
Both
|
$480.00
|
|
|
Service Code
|
HCPCS 67938
|
| Min. Negotiated Rate |
$105.64 |
| Max. Negotiated Rate |
$312.00 |
| Rate for Payer: Aetna Commercial |
$141.56
|
| Rate for Payer: Aetna Medicare |
$109.87
|
| Rate for Payer: BCBS Complete |
$192.00
|
| Rate for Payer: BCBS MAPPO |
$105.64
|
| Rate for Payer: BCN Medicare Advantage |
$105.64
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cofinity Commercial |
$152.12
|
| Rate for Payer: Cofinity Commercial |
$141.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.92
|
| Rate for Payer: Nomi Health Commercial |
$126.77
|
| Rate for Payer: PACE SWMI |
$105.64
|
| Rate for Payer: PHP Medicare Advantage |
$105.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.00
|
| Rate for Payer: Priority Health Medicare |
$106.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.64
|
| Rate for Payer: UHC Exchange |
$105.64
|
| Rate for Payer: UHC Medicare Advantage |
$105.64
|
|
