|
PR THYROIDECTOMY TOTAL/SUBTOTAL RAD NECK DISSECT
|
Professional
|
Both
|
$3,256.00
|
|
|
Service Code
|
HCPCS 60254
|
| Min. Negotiated Rate |
$944.87 |
| Max. Negotiated Rate |
$2,706.92 |
| Rate for Payer: Aetna Commercial |
$2,140.95
|
| Rate for Payer: Aetna Medicare |
$1,628.00
|
| Rate for Payer: BCBS Complete |
$992.11
|
| Rate for Payer: BCN Commercial |
$2,496.38
|
| Rate for Payer: Cash Price |
$2,604.80
|
| Rate for Payer: Cash Price |
$2,604.80
|
| Rate for Payer: Mclaren Medicaid |
$944.87
|
| Rate for Payer: Meridian Medicaid |
$992.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,442.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$944.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,706.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,706.92
|
| Rate for Payer: UHC Medicaid |
$944.87
|
| Rate for Payer: UHCCP Medicaid |
$944.87
|
|
|
PR THYROIDECT W/SUBSTERNAL SPLIT/TRANSTHORACIC
|
Professional
|
Both
|
$5,617.00
|
|
|
Service Code
|
HCPCS 60270
|
| Min. Negotiated Rate |
$783.63 |
| Max. Negotiated Rate |
$4,212.75 |
| Rate for Payer: Aetna Commercial |
$1,762.15
|
| Rate for Payer: Aetna Medicare |
$2,808.50
|
| Rate for Payer: BCBS Complete |
$822.81
|
| Rate for Payer: BCN Commercial |
$2,039.24
|
| Rate for Payer: Cash Price |
$4,493.60
|
| Rate for Payer: Cash Price |
$4,493.60
|
| Rate for Payer: Mclaren Medicaid |
$783.63
|
| Rate for Payer: Meridian Medicaid |
$822.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,212.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$783.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,211.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,211.22
|
| Rate for Payer: UHC Medicaid |
$783.63
|
| Rate for Payer: UHCCP Medicaid |
$783.63
|
|
|
PR TIS CLTR SKN AGRFT F/S/N/H/F/G/M/DGT 1ST 25SQCM/
|
Professional
|
Both
|
$1,365.00
|
|
|
Service Code
|
HCPCS 15155
|
| Min. Negotiated Rate |
$418.97 |
| Max. Negotiated Rate |
$1,100.54 |
| Rate for Payer: Aetna Commercial |
$787.97
|
| Rate for Payer: Aetna Medicare |
$682.50
|
| Rate for Payer: BCBS Complete |
$439.92
|
| Rate for Payer: BCN Commercial |
$1,100.54
|
| Rate for Payer: Cash Price |
$1,092.00
|
| Rate for Payer: Cash Price |
$1,092.00
|
| Rate for Payer: Mclaren Medicaid |
$418.97
|
| Rate for Payer: Meridian Medicaid |
$439.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,023.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,007.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,007.28
|
| Rate for Payer: UHC Medicaid |
$418.97
|
| Rate for Payer: UHCCP Medicaid |
$418.97
|
|
|
PR TIS CLTR SKN AGRFT F/S/N/H/F/G/M/DGT AD 1-75SQCM
|
Professional
|
Both
|
$368.00
|
|
|
Service Code
|
HCPCS 15156
|
| Min. Negotiated Rate |
$86.05 |
| Max. Negotiated Rate |
$276.00 |
| Rate for Payer: Aetna Commercial |
$166.77
|
| Rate for Payer: Aetna Medicare |
$184.00
|
| Rate for Payer: BCBS Complete |
$90.35
|
| Rate for Payer: BCN Commercial |
$224.09
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Mclaren Medicaid |
$86.05
|
| Rate for Payer: Meridian Medicaid |
$90.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$205.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$205.10
|
| Rate for Payer: UHC Medicaid |
$86.05
|
| Rate for Payer: UHCCP Medicaid |
$86.05
|
|
|
PR TISS CLTR SKIN AGRFT T/A/L EA ADD 100 SQCM/EA 1%
|
Professional
|
Both
|
$315.00
|
|
|
Service Code
|
HCPCS 15152
|
| Min. Negotiated Rate |
$78.17 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: Aetna Commercial |
$151.77
|
| Rate for Payer: Aetna Medicare |
$157.50
|
| Rate for Payer: BCBS Complete |
$82.08
|
| Rate for Payer: BCN Commercial |
$215.63
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Mclaren Medicaid |
$78.17
|
| Rate for Payer: Meridian Medicaid |
$82.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$197.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$197.35
|
| Rate for Payer: UHC Medicaid |
$78.17
|
| Rate for Payer: UHCCP Medicaid |
$78.17
|
|
|
PR TISS CLTR SKIN AUTOGRAFT T/A/L 1ST 25 SQ CM/<
|
Professional
|
Both
|
$1,241.00
|
|
|
Service Code
|
HCPCS 15150
|
| Min. Negotiated Rate |
$393.62 |
| Max. Negotiated Rate |
$964.59 |
| Rate for Payer: Aetna Commercial |
$698.22
|
| Rate for Payer: Aetna Medicare |
$620.50
|
| Rate for Payer: BCBS Complete |
$413.30
|
| Rate for Payer: BCN Commercial |
$964.59
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Cash Price |
$992.80
|
| Rate for Payer: Mclaren Medicaid |
$393.62
|
| Rate for Payer: Meridian Medicaid |
$413.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$930.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$393.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$882.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$882.85
|
| Rate for Payer: UHC Medicaid |
$393.62
|
| Rate for Payer: UHCCP Medicaid |
$393.62
|
|
|
PR TISS CLTR SKIN AUTOGRAFT T/A/L ADDL 1-75 SQCM
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 15151
|
| Min. Negotiated Rate |
$62.20 |
| Max. Negotiated Rate |
$177.75 |
| Rate for Payer: Aetna Commercial |
$120.68
|
| Rate for Payer: Aetna Medicare |
$118.50
|
| Rate for Payer: BCBS Complete |
$65.31
|
| Rate for Payer: BCN Commercial |
$162.34
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Mclaren Medicaid |
$62.20
|
| Rate for Payer: Meridian Medicaid |
$65.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$148.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.59
|
| Rate for Payer: UHC Medicaid |
$62.20
|
| Rate for Payer: UHCCP Medicaid |
$62.20
|
|
|
PR TISSUE EXPANDER PLACEMENT BREAST RECONSTRUCTION
|
Professional
|
Both
|
$2,521.00
|
|
|
Service Code
|
HCPCS 19357
|
| Min. Negotiated Rate |
$684.16 |
| Max. Negotiated Rate |
$1,890.75 |
| Rate for Payer: Aetna Commercial |
$1,253.56
|
| Rate for Payer: Aetna Medicare |
$1,260.50
|
| Rate for Payer: BCBS Complete |
$718.37
|
| Rate for Payer: BCN Commercial |
$1,755.88
|
| Rate for Payer: Cash Price |
$2,016.80
|
| Rate for Payer: Cash Price |
$2,016.80
|
| Rate for Payer: Mclaren Medicaid |
$684.16
|
| Rate for Payer: Meridian Medicaid |
$718.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,890.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$684.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,607.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,607.09
|
| Rate for Payer: UHC Medicaid |
$684.16
|
| Rate for Payer: UHCCP Medicaid |
$684.16
|
|
|
PR TIXAGEV AND CILGAV INJ
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS M0220
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$150.50
|
| Rate for Payer: Aetna Medicare |
$105.00
|
| Rate for Payer: BCBS Complete |
$84.00
|
| Rate for Payer: BCN Commercial |
$97.45
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
|
|
PR TMPP ANTRT/MASTOIDOTOMY PROSTHESIS TORP
|
Professional
|
Both
|
$3,713.00
|
|
|
Service Code
|
HCPCS 69637
|
| Min. Negotiated Rate |
$819.20 |
| Max. Negotiated Rate |
$2,784.75 |
| Rate for Payer: Aetna Commercial |
$1,624.04
|
| Rate for Payer: Aetna Medicare |
$1,856.50
|
| Rate for Payer: BCBS Complete |
$860.16
|
| Rate for Payer: BCN Commercial |
$2,097.00
|
| Rate for Payer: Cash Price |
$2,970.40
|
| Rate for Payer: Cash Price |
$2,970.40
|
| Rate for Payer: Mclaren Medicaid |
$819.20
|
| Rate for Payer: Meridian Medicaid |
$860.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,784.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$819.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,072.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,072.04
|
| Rate for Payer: UHC Medicaid |
$819.20
|
| Rate for Payer: UHCCP Medicaid |
$819.20
|
|
|
PR TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR
|
Professional
|
Both
|
$4,439.00
|
|
|
Service Code
|
HCPCS 69644
|
| Min. Negotiated Rate |
$874.58 |
| Max. Negotiated Rate |
$3,329.25 |
| Rate for Payer: Aetna Commercial |
$1,699.51
|
| Rate for Payer: Aetna Medicare |
$2,219.50
|
| Rate for Payer: BCBS Complete |
$918.31
|
| Rate for Payer: BCN Commercial |
$2,255.86
|
| Rate for Payer: Cash Price |
$3,551.20
|
| Rate for Payer: Cash Price |
$3,551.20
|
| Rate for Payer: Mclaren Medicaid |
$874.58
|
| Rate for Payer: Meridian Medicaid |
$918.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,329.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$874.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,229.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,229.01
|
| Rate for Payer: UHC Medicaid |
$874.58
|
| Rate for Payer: UHCCP Medicaid |
$874.58
|
|
|
PR TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR
|
Professional
|
Both
|
$4,198.00
|
|
|
Service Code
|
HCPCS 69643
|
| Min. Negotiated Rate |
$693.53 |
| Max. Negotiated Rate |
$3,148.50 |
| Rate for Payer: Aetna Commercial |
$1,396.70
|
| Rate for Payer: Aetna Medicare |
$2,099.00
|
| Rate for Payer: BCBS Complete |
$728.21
|
| Rate for Payer: BCN Commercial |
$1,823.61
|
| Rate for Payer: Cash Price |
$3,358.40
|
| Rate for Payer: Cash Price |
$3,358.40
|
| Rate for Payer: Mclaren Medicaid |
$693.53
|
| Rate for Payer: Meridian Medicaid |
$728.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,148.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$693.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,801.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,801.91
|
| Rate for Payer: UHC Medicaid |
$693.53
|
| Rate for Payer: UHCCP Medicaid |
$693.53
|
|
|
PR TMPP MASTOIDECTOMY W/O OSSICULAR CHAIN RECNSTJ
|
Professional
|
Both
|
$4,049.00
|
|
|
Service Code
|
HCPCS 69641
|
| Min. Negotiated Rate |
$591.93 |
| Max. Negotiated Rate |
$3,036.75 |
| Rate for Payer: Aetna Commercial |
$1,185.92
|
| Rate for Payer: Aetna Medicare |
$2,024.50
|
| Rate for Payer: BCBS Complete |
$621.53
|
| Rate for Payer: BCN Commercial |
$1,554.19
|
| Rate for Payer: Cash Price |
$3,239.20
|
| Rate for Payer: Cash Price |
$3,239.20
|
| Rate for Payer: Mclaren Medicaid |
$591.93
|
| Rate for Payer: Meridian Medicaid |
$621.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,036.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$591.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,535.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,535.70
|
| Rate for Payer: UHC Medicaid |
$591.93
|
| Rate for Payer: UHCCP Medicaid |
$591.93
|
|
|
PR TMPP MASTOIDECTOMY W/OSSICULAR CHAIN RECNSTJ
|
Professional
|
Both
|
$2,765.00
|
|
|
Service Code
|
HCPCS 69642
|
| Min. Negotiated Rate |
$755.51 |
| Max. Negotiated Rate |
$2,073.75 |
| Rate for Payer: Aetna Commercial |
$1,523.27
|
| Rate for Payer: Aetna Medicare |
$1,382.50
|
| Rate for Payer: BCBS Complete |
$793.29
|
| Rate for Payer: BCN Commercial |
$1,993.42
|
| Rate for Payer: Cash Price |
$2,212.00
|
| Rate for Payer: Cash Price |
$2,212.00
|
| Rate for Payer: Mclaren Medicaid |
$755.51
|
| Rate for Payer: Meridian Medicaid |
$793.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,073.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$755.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,969.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,969.69
|
| Rate for Payer: UHC Medicaid |
$755.51
|
| Rate for Payer: UHCCP Medicaid |
$755.51
|
|
|
PR TMVI W/PROSTHETIC VALVE PERCUTANEOUS APPROACH
|
Professional
|
Both
|
$3,872.00
|
|
|
Service Code
|
HCPCS 0483T
|
| Min. Negotiated Rate |
$1,415.73 |
| Max. Negotiated Rate |
$2,904.00 |
| Rate for Payer: Aetna Commercial |
$1,415.73
|
| Rate for Payer: Aetna Medicare |
$1,936.00
|
| Rate for Payer: BCBS Complete |
$1,548.80
|
| Rate for Payer: BCN Commercial |
$2,635.81
|
| Rate for Payer: Cash Price |
$3,097.60
|
| Rate for Payer: Cash Price |
$3,097.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,904.00
|
|
|
PR TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN
|
Professional
|
Both
|
$1,787.00
|
|
|
Service Code
|
HCPCS 27681
|
| Min. Negotiated Rate |
$312.26 |
| Max. Negotiated Rate |
$1,340.25 |
| Rate for Payer: Aetna Commercial |
$686.91
|
| Rate for Payer: Aetna Medicare |
$893.50
|
| Rate for Payer: BCBS Complete |
$327.87
|
| Rate for Payer: BCN Commercial |
$777.35
|
| Rate for Payer: Cash Price |
$1,429.60
|
| Rate for Payer: Cash Price |
$1,429.60
|
| Rate for Payer: Mclaren Medicaid |
$312.26
|
| Rate for Payer: Meridian Medicaid |
$327.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,340.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$312.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$830.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$830.97
|
| Rate for Payer: UHC Medicaid |
$312.26
|
| Rate for Payer: UHCCP Medicaid |
$312.26
|
|
|
PR TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Professional
|
Both
|
$1,518.00
|
|
|
Service Code
|
HCPCS 25295
|
| Min. Negotiated Rate |
$316.94 |
| Max. Negotiated Rate |
$1,138.50 |
| Rate for Payer: Aetna Commercial |
$701.07
|
| Rate for Payer: Aetna Medicare |
$759.00
|
| Rate for Payer: BCBS Complete |
$332.79
|
| Rate for Payer: BCN Commercial |
$812.21
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Cash Price |
$1,214.40
|
| Rate for Payer: Mclaren Medicaid |
$316.94
|
| Rate for Payer: Meridian Medicaid |
$332.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,138.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$868.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$868.22
|
| Rate for Payer: UHC Medicaid |
$316.94
|
| Rate for Payer: UHCCP Medicaid |
$316.94
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN
|
Professional
|
Both
|
$1,604.00
|
|
|
Service Code
|
HCPCS 24358
|
| Min. Negotiated Rate |
$318.86 |
| Max. Negotiated Rate |
$1,203.00 |
| Rate for Payer: Aetna Commercial |
$702.23
|
| Rate for Payer: Aetna Medicare |
$802.00
|
| Rate for Payer: BCBS Complete |
$334.80
|
| Rate for Payer: BCN Commercial |
$817.69
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Cash Price |
$1,283.20
|
| Rate for Payer: Mclaren Medicaid |
$318.86
|
| Rate for Payer: Meridian Medicaid |
$334.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,203.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$318.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$874.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$874.08
|
| Rate for Payer: UHC Medicaid |
$318.86
|
| Rate for Payer: UHCCP Medicaid |
$318.86
|
|
|
PR TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR
|
Professional
|
Both
|
$1,909.00
|
|
|
Service Code
|
HCPCS 24359
|
| Min. Negotiated Rate |
$393.41 |
| Max. Negotiated Rate |
$1,431.75 |
| Rate for Payer: Aetna Commercial |
$883.30
|
| Rate for Payer: Aetna Medicare |
$954.50
|
| Rate for Payer: BCBS Complete |
$413.08
|
| Rate for Payer: BCN Commercial |
$1,016.38
|
| Rate for Payer: Cash Price |
$1,527.20
|
| Rate for Payer: Cash Price |
$1,527.20
|
| Rate for Payer: Mclaren Medicaid |
$393.41
|
| Rate for Payer: Meridian Medicaid |
$413.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,431.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$393.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,086.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,086.48
|
| Rate for Payer: UHC Medicaid |
$393.41
|
| Rate for Payer: UHCCP Medicaid |
$393.41
|
|
|
PR TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Professional
|
Both
|
$1,314.00
|
|
|
Service Code
|
HCPCS 25290
|
| Min. Negotiated Rate |
$264.33 |
| Max. Negotiated Rate |
$985.50 |
| Rate for Payer: Aetna Commercial |
$579.85
|
| Rate for Payer: Aetna Medicare |
$657.00
|
| Rate for Payer: BCBS Complete |
$277.55
|
| Rate for Payer: BCN Commercial |
$674.76
|
| Rate for Payer: Cash Price |
$1,051.20
|
| Rate for Payer: Cash Price |
$1,051.20
|
| Rate for Payer: Mclaren Medicaid |
$264.33
|
| Rate for Payer: Meridian Medicaid |
$277.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$985.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$264.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$721.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$721.31
|
| Rate for Payer: UHC Medicaid |
$264.33
|
| Rate for Payer: UHCCP Medicaid |
$264.33
|
|
|
PR TOBACCO USE CESSATION INTENSIVE >10 MINUTES
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 99407
|
| Min. Negotiated Rate |
$14.06 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Commercial |
$26.18
|
| Rate for Payer: Aetna Medicare |
$21.50
|
| Rate for Payer: BCBS Complete |
$14.76
|
| Rate for Payer: BCN Commercial |
$26.88
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Mclaren Medicaid |
$14.06
|
| Rate for Payer: Meridian Medicaid |
$14.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.15
|
| Rate for Payer: UHC Medicaid |
$14.06
|
| Rate for Payer: UHCCP Medicaid |
$14.06
|
|
|
PR TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 99406
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Commercial |
$12.73
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCN Commercial |
$12.72
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Mclaren Medicaid |
$6.82
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.68
|
| Rate for Payer: UHC Medicaid |
$6.82
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
|
|
PR TOBACCO-USE COUNSEL>10MIN
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS G0437
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$36.75 |
| Rate for Payer: Aetna Medicare |
$24.50
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.16
|
|
|
PR TOBACCO-USE COUNSEL 3-10 MIN
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS G0436
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Aetna Medicare |
$12.50
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.42
|
|
|
PR TONE DECAY TEST
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 92563
|
| Min. Negotiated Rate |
$29.50 |
| Max. Negotiated Rate |
$53.29 |
| Rate for Payer: Aetna Commercial |
$32.42
|
| Rate for Payer: Aetna Medicare |
$29.50
|
| Rate for Payer: BCN Commercial |
$53.29
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.14
|
|
