|
PR AFO MULTILIG ANK SUP PRE OTS
|
Professional
|
Both
|
$108.00
|
|
|
Service Code
|
HCPCS L1906
|
| Min. Negotiated Rate |
$43.20 |
| Max. Negotiated Rate |
$106.78 |
| Rate for Payer: Aetna Commercial |
$67.73
|
| Rate for Payer: BCBS Complete |
$43.20
|
| Rate for Payer: BCN Commercial |
$106.78
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.60
|
|
|
PR AIIV4 VACC INACTIVATED PRSRV FR 0.5ML DOS IM USE
|
Professional
|
Both
|
$178.26
|
|
|
Service Code
|
HCPCS 90694
|
| Min. Negotiated Rate |
$71.30 |
| Max. Negotiated Rate |
$124.78 |
| Rate for Payer: Aetna Commercial |
$96.05
|
| Rate for Payer: Aetna Medicare |
$71.68
|
| Rate for Payer: BCBS Complete |
$71.30
|
| Rate for Payer: BCBS MAPPO |
$71.68
|
| Rate for Payer: BCBS Trust/PPO |
$77.36
|
| Rate for Payer: BCN Commercial |
$71.68
|
| Rate for Payer: BCN Medicare Advantage |
$71.68
|
| Rate for Payer: Cash Price |
$142.61
|
| Rate for Payer: Cash Price |
$142.61
|
| Rate for Payer: Cofinity Commercial |
$96.05
|
| Rate for Payer: Cofinity Commercial |
$103.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.68
|
| Rate for Payer: Healthscope Commercial |
$86.02
|
| Rate for Payer: Healthscope Whirlpool |
$86.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.27
|
| Rate for Payer: PACE SWMI |
$71.68
|
| Rate for Payer: PHP Medicare Advantage |
$71.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.78
|
| Rate for Payer: Priority Health Medicare |
$71.68
|
| Rate for Payer: UHC Medicare Advantage |
$73.83
|
|
|
PR AK SLEEVE SUSP NEOPRENE/EQUA
|
Professional
|
Both
|
$156.00
|
|
|
Service Code
|
HCPCS L5695
|
| Min. Negotiated Rate |
$62.40 |
| Max. Negotiated Rate |
$171.39 |
| Rate for Payer: Aetna Commercial |
$97.85
|
| Rate for Payer: BCBS Complete |
$62.40
|
| Rate for Payer: BCN Commercial |
$171.39
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.20
|
|
|
PR ALBUTEROL IPRATROP NON-COMP
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS J7620
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$1.40 |
| Rate for Payer: Aetna Commercial |
$0.18
|
| Rate for Payer: Aetna Medicare |
$0.13
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: BCBS MAPPO |
$0.13
|
| Rate for Payer: BCN Commercial |
$0.02
|
| Rate for Payer: BCN Medicare Advantage |
$0.13
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cofinity Commercial |
$0.19
|
| Rate for Payer: Cofinity Commercial |
$0.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.13
|
| Rate for Payer: Healthscope Commercial |
$0.16
|
| Rate for Payer: Healthscope Whirlpool |
$0.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.14
|
| Rate for Payer: PACE SWMI |
$0.13
|
| Rate for Payer: PHP Medicare Advantage |
$0.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.40
|
| Rate for Payer: Priority Health Medicare |
$0.13
|
| Rate for Payer: UHC Medicare Advantage |
$0.13
|
|
|
PR ALBUTEROL NON-COMP CON
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS J7611
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$1.40 |
| Rate for Payer: Aetna Commercial |
$0.18
|
| Rate for Payer: Aetna Medicare |
$0.13
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: BCBS MAPPO |
$0.13
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: BCN Medicare Advantage |
$0.13
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cofinity Commercial |
$0.18
|
| Rate for Payer: Cofinity Commercial |
$0.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.13
|
| Rate for Payer: Healthscope Commercial |
$0.16
|
| Rate for Payer: Healthscope Whirlpool |
$0.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.14
|
| Rate for Payer: PACE SWMI |
$0.13
|
| Rate for Payer: PHP Medicare Advantage |
$0.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.40
|
| Rate for Payer: Priority Health Medicare |
$0.13
|
| Rate for Payer: UHC Medicare Advantage |
$0.14
|
|
|
PR ALBUTEROL NON-COMP UNIT
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS J7613
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1.40 |
| Rate for Payer: Aetna Commercial |
$0.04
|
| Rate for Payer: Aetna Medicare |
$0.03
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: BCBS MAPPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.03
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cofinity Commercial |
$0.04
|
| Rate for Payer: Cofinity Commercial |
$0.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.03
|
| Rate for Payer: Healthscope Commercial |
$0.04
|
| Rate for Payer: Healthscope Whirlpool |
$0.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$0.03
|
| Rate for Payer: PACE SWMI |
$0.03
|
| Rate for Payer: PHP Medicare Advantage |
$0.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.40
|
| Rate for Payer: Priority Health Medicare |
$0.03
|
| Rate for Payer: UHC Medicare Advantage |
$0.03
|
|
|
PR ALCOHOL AND/OR DRUG SERVICES
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS H0015
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$169.40 |
| Rate for Payer: Aetna Commercial |
$134.33
|
| Rate for Payer: BCBS Complete |
$96.80
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.40
|
|
|
PR ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 99408
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$1,099.92 |
| Rate for Payer: Aetna Commercial |
$33.63
|
| Rate for Payer: BCBS Complete |
$21.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.92
|
| Rate for Payer: BCN Commercial |
$50.33
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Meridian Medicaid |
$21.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.26
|
| Rate for Payer: Priority Health Narrow Network |
$40.26
|
|
|
PR ALCOHOL/SUBSTANCE SCREEN & INTERVENTION >30 MIN
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 99409
|
| Min. Negotiated Rate |
$40.04 |
| Max. Negotiated Rate |
$1,109.43 |
| Rate for Payer: Aetna Commercial |
$67.61
|
| Rate for Payer: BCBS Complete |
$42.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,109.43
|
| Rate for Payer: BCN Commercial |
$96.27
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Meridian Medicaid |
$42.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.53
|
| Rate for Payer: Priority Health Narrow Network |
$80.53
|
|
|
PR ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED
|
Professional
|
Both
|
$479.00
|
|
|
Service Code
|
HCPCS 20930
|
| Min. Negotiated Rate |
$135.79 |
| Max. Negotiated Rate |
$11,952.59 |
| Rate for Payer: Aetna Commercial |
$155.86
|
| Rate for Payer: BCBS Complete |
$191.60
|
| Rate for Payer: BCBS Trust/PPO |
$11,952.59
|
| Rate for Payer: BCN Commercial |
$135.79
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Cash Price |
$383.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$335.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.73
|
| Rate for Payer: Priority Health Narrow Network |
$178.73
|
|
|
PR ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL
|
Professional
|
Both
|
$437.00
|
|
|
Service Code
|
HCPCS 20931
|
| Min. Negotiated Rate |
$70.29 |
| Max. Negotiated Rate |
$29,358.48 |
| Rate for Payer: Aetna Commercial |
$147.76
|
| Rate for Payer: Aetna Medicare |
$110.27
|
| Rate for Payer: BCBS Complete |
$73.80
|
| Rate for Payer: BCBS MAPPO |
$110.27
|
| Rate for Payer: BCBS Trust/PPO |
$29,358.48
|
| Rate for Payer: BCN Commercial |
$177.03
|
| Rate for Payer: BCN Medicare Advantage |
$110.27
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cofinity Commercial |
$158.79
|
| Rate for Payer: Cofinity Commercial |
$147.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.27
|
| Rate for Payer: Healthscope Commercial |
$132.32
|
| Rate for Payer: Healthscope Whirlpool |
$132.32
|
| Rate for Payer: Meridian Medicaid |
$73.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$115.78
|
| Rate for Payer: PACE SWMI |
$110.27
|
| Rate for Payer: PHP Medicare Advantage |
$110.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.01
|
| Rate for Payer: Priority Health Medicare |
$110.27
|
| Rate for Payer: Priority Health Narrow Network |
$168.01
|
| Rate for Payer: UHC Medicare Advantage |
$113.58
|
|
|
PR ALTEPLASE RECOMBINANT
|
Professional
|
Both
|
$89.00
|
|
|
Service Code
|
HCPCS J2997
|
| Min. Negotiated Rate |
$35.60 |
| Max. Negotiated Rate |
$128.37 |
| Rate for Payer: Aetna Commercial |
$119.46
|
| Rate for Payer: Aetna Medicare |
$89.15
|
| Rate for Payer: BCBS Complete |
$35.60
|
| Rate for Payer: BCBS MAPPO |
$89.15
|
| Rate for Payer: BCBS Trust/PPO |
$88.53
|
| Rate for Payer: BCN Commercial |
$87.12
|
| Rate for Payer: BCN Medicare Advantage |
$89.15
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cofinity Commercial |
$119.46
|
| Rate for Payer: Cofinity Commercial |
$128.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.15
|
| Rate for Payer: Healthscope Commercial |
$106.98
|
| Rate for Payer: Healthscope Whirlpool |
$106.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$93.60
|
| Rate for Payer: PACE SWMI |
$89.15
|
| Rate for Payer: PHP Medicare Advantage |
$89.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.30
|
| Rate for Payer: Priority Health Medicare |
$89.15
|
| Rate for Payer: UHC Medicare Advantage |
$91.82
|
|
|
PR AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
HCPCS 93784
|
| Min. Negotiated Rate |
$37.78 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Aetna Commercial |
$58.02
|
| Rate for Payer: Aetna Medicare |
$43.30
|
| Rate for Payer: BCBS Complete |
$100.80
|
| Rate for Payer: BCBS MAPPO |
$43.30
|
| Rate for Payer: BCBS Trust/PPO |
$37.78
|
| Rate for Payer: BCN Commercial |
$66.46
|
| Rate for Payer: BCN Medicare Advantage |
$43.30
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$58.02
|
| Rate for Payer: Cofinity Commercial |
$62.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.30
|
| Rate for Payer: Healthscope Commercial |
$51.96
|
| Rate for Payer: Healthscope Whirlpool |
$51.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.46
|
| Rate for Payer: PACE SWMI |
$43.30
|
| Rate for Payer: PHP Medicare Advantage |
$43.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.31
|
| Rate for Payer: Priority Health Medicare |
$43.30
|
| Rate for Payer: Priority Health Narrow Network |
$64.31
|
| Rate for Payer: UHC Medicare Advantage |
$44.60
|
|
|
PR AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R
|
Professional
|
Both
|
$35.00
|
|
|
Service Code
|
HCPCS 93790
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$31.84 |
| Rate for Payer: Aetna Commercial |
$23.53
|
| Rate for Payer: Aetna Medicare |
$17.56
|
| Rate for Payer: BCBS Complete |
$14.00
|
| Rate for Payer: BCBS MAPPO |
$17.56
|
| Rate for Payer: BCBS Trust/PPO |
$31.84
|
| Rate for Payer: BCN Commercial |
$25.90
|
| Rate for Payer: BCN Medicare Advantage |
$17.56
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cofinity Commercial |
$25.29
|
| Rate for Payer: Cofinity Commercial |
$23.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.56
|
| Rate for Payer: Healthscope Commercial |
$21.07
|
| Rate for Payer: Healthscope Whirlpool |
$21.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.44
|
| Rate for Payer: PACE SWMI |
$17.56
|
| Rate for Payer: PHP Medicare Advantage |
$17.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.06
|
| Rate for Payer: Priority Health Medicare |
$17.56
|
| Rate for Payer: Priority Health Narrow Network |
$25.06
|
| Rate for Payer: UHC Medicare Advantage |
$18.09
|
|
|
PR AMBULATORY EEG MONITORING
|
Professional
|
Both
|
$573.00
|
|
|
Service Code
|
HCPCS 95950
|
| Min. Negotiated Rate |
$229.20 |
| Max. Negotiated Rate |
$401.10 |
| Rate for Payer: BCBS Complete |
$229.20
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.10
|
|
|
PR AMINOLEVULINIC ACID HCL TOP
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
HCPCS J7308
|
| Min. Negotiated Rate |
$69.60 |
| Max. Negotiated Rate |
$563.37 |
| Rate for Payer: Aetna Commercial |
$524.25
|
| Rate for Payer: Aetna Medicare |
$391.23
|
| Rate for Payer: BCBS Complete |
$69.60
|
| Rate for Payer: BCBS MAPPO |
$391.23
|
| Rate for Payer: BCBS Trust/PPO |
$399.72
|
| Rate for Payer: BCN Commercial |
$388.57
|
| Rate for Payer: BCN Medicare Advantage |
$391.23
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cofinity Commercial |
$563.37
|
| Rate for Payer: Cofinity Commercial |
$524.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.23
|
| Rate for Payer: Healthscope Commercial |
$469.48
|
| Rate for Payer: Healthscope Whirlpool |
$469.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$410.79
|
| Rate for Payer: PACE SWMI |
$391.23
|
| Rate for Payer: PHP Medicare Advantage |
$391.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.80
|
| Rate for Payer: Priority Health Medicare |
$391.23
|
| Rate for Payer: UHC Medicare Advantage |
$402.97
|
|
|
PRAMIPEXOLE 0.125 MG TABLET
|
Facility
|
IP
|
$109.98
|
|
|
Service Code
|
NDC 13668-091-90
|
| Hospital Charge Code |
21287
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$76.99 |
| Max. Negotiated Rate |
$109.98 |
| Rate for Payer: Aetna Commercial |
$98.98
|
| Rate for Payer: ASR ASR |
$106.68
|
| Rate for Payer: BCBS Trust/PPO |
$85.27
|
| Rate for Payer: BCN Commercial |
$85.27
|
| Rate for Payer: Cash Price |
$87.98
|
| Rate for Payer: Cofinity Commercial |
$103.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.98
|
| Rate for Payer: Healthscope Commercial |
$109.98
|
| Rate for Payer: Healthscope Whirlpool |
$106.68
|
| Rate for Payer: Mclaren Commercial |
$98.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$96.78
|
|
|
PRAMIPEXOLE 0.25 MG TABLET
|
Facility
|
IP
|
$432.40
|
|
|
Service Code
|
NDC 0904-6704-61
|
| Hospital Charge Code |
21290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$302.68 |
| Max. Negotiated Rate |
$432.40 |
| Rate for Payer: Aetna Commercial |
$389.16
|
| Rate for Payer: ASR ASR |
$419.43
|
| Rate for Payer: BCBS Trust/PPO |
$335.24
|
| Rate for Payer: BCN Commercial |
$335.24
|
| Rate for Payer: Cash Price |
$345.92
|
| Rate for Payer: Cofinity Commercial |
$406.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$345.92
|
| Rate for Payer: Healthscope Commercial |
$432.40
|
| Rate for Payer: Healthscope Whirlpool |
$419.43
|
| Rate for Payer: Mclaren Commercial |
$389.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$367.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$302.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$380.51
|
|
|
PRAMIPEXOLE 0.25 MG TABLET
|
Facility
|
IP
|
$107.86
|
|
|
Service Code
|
NDC 13668-092-90
|
| Hospital Charge Code |
21290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$75.50 |
| Max. Negotiated Rate |
$107.86 |
| Rate for Payer: Aetna Commercial |
$97.07
|
| Rate for Payer: ASR ASR |
$104.62
|
| Rate for Payer: BCBS Trust/PPO |
$83.62
|
| Rate for Payer: BCN Commercial |
$83.62
|
| Rate for Payer: Cash Price |
$86.29
|
| Rate for Payer: Cofinity Commercial |
$101.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.29
|
| Rate for Payer: Healthscope Commercial |
$107.86
|
| Rate for Payer: Healthscope Whirlpool |
$104.62
|
| Rate for Payer: Mclaren Commercial |
$97.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.92
|
|
|
PRAMIPEXOLE 0.25 MG TABLET
|
Facility
|
IP
|
$2,550.78
|
|
|
Service Code
|
NDC 0597-0184-61
|
| Hospital Charge Code |
21290
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,785.55 |
| Max. Negotiated Rate |
$2,550.78 |
| Rate for Payer: Aetna Commercial |
$2,295.70
|
| Rate for Payer: ASR ASR |
$2,474.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,977.62
|
| Rate for Payer: BCN Commercial |
$1,977.62
|
| Rate for Payer: Cash Price |
$2,040.62
|
| Rate for Payer: Cofinity Commercial |
$2,397.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.62
|
| Rate for Payer: Healthscope Commercial |
$2,550.78
|
| Rate for Payer: Healthscope Whirlpool |
$2,474.26
|
| Rate for Payer: Mclaren Commercial |
$2,295.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,168.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,785.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,244.69
|
|
|
PR AMNIOCENTESIS DIAGNOSIC
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 59000
|
| Min. Negotiated Rate |
$51.76 |
| Max. Negotiated Rate |
$570.04 |
| Rate for Payer: Aetna Commercial |
$107.39
|
| Rate for Payer: Aetna Medicare |
$80.14
|
| Rate for Payer: BCBS Complete |
$54.35
|
| Rate for Payer: BCBS MAPPO |
$80.14
|
| Rate for Payer: BCBS Trust/PPO |
$570.04
|
| Rate for Payer: BCN Commercial |
$172.01
|
| Rate for Payer: BCN Medicare Advantage |
$80.14
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$115.40
|
| Rate for Payer: Cofinity Commercial |
$107.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.14
|
| Rate for Payer: Healthscope Commercial |
$96.17
|
| Rate for Payer: Healthscope Whirlpool |
$96.17
|
| Rate for Payer: Meridian Medicaid |
$54.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.15
|
| Rate for Payer: PACE SWMI |
$80.14
|
| Rate for Payer: PHP Medicare Advantage |
$80.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$113.32
|
| Rate for Payer: Priority Health Medicare |
$80.14
|
| Rate for Payer: Priority Health Narrow Network |
$113.32
|
| Rate for Payer: UHC Medicare Advantage |
$82.54
|
|
|
PR AMNIOCENTESIS THER AMNIOTIC FLUID RDCTJ US GUID
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 59001
|
| Min. Negotiated Rate |
$113.96 |
| Max. Negotiated Rate |
$523.55 |
| Rate for Payer: Aetna Commercial |
$238.95
|
| Rate for Payer: Aetna Medicare |
$178.32
|
| Rate for Payer: BCBS Complete |
$119.66
|
| Rate for Payer: BCBS MAPPO |
$178.32
|
| Rate for Payer: BCBS Trust/PPO |
$523.55
|
| Rate for Payer: BCN Commercial |
$259.98
|
| Rate for Payer: BCN Medicare Advantage |
$178.32
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$256.78
|
| Rate for Payer: Cofinity Commercial |
$238.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.32
|
| Rate for Payer: Healthscope Commercial |
$213.98
|
| Rate for Payer: Healthscope Whirlpool |
$213.98
|
| Rate for Payer: Meridian Medicaid |
$119.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$187.24
|
| Rate for Payer: PACE SWMI |
$178.32
|
| Rate for Payer: PHP Medicare Advantage |
$178.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$251.20
|
| Rate for Payer: Priority Health Medicare |
$178.32
|
| Rate for Payer: Priority Health Narrow Network |
$251.20
|
| Rate for Payer: UHC Medicare Advantage |
$183.67
|
|
|
PR AMP ARM THRU HUMERUS SECONDARY CLSR/SCAR REVJ
|
Professional
|
Both
|
$1,560.00
|
|
|
Service Code
|
HCPCS 24925
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$1,092.00 |
| Rate for Payer: Aetna Commercial |
$754.18
|
| Rate for Payer: Aetna Medicare |
$562.82
|
| Rate for Payer: BCBS Complete |
$389.60
|
| Rate for Payer: BCBS MAPPO |
$562.82
|
| Rate for Payer: BCBS Trust/PPO |
$140.00
|
| Rate for Payer: BCN Commercial |
$842.97
|
| Rate for Payer: BCN Medicare Advantage |
$562.82
|
| Rate for Payer: Cash Price |
$1,248.00
|
| Rate for Payer: Cash Price |
$1,248.00
|
| Rate for Payer: Cofinity Commercial |
$810.46
|
| Rate for Payer: Cofinity Commercial |
$754.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.82
|
| Rate for Payer: Healthscope Commercial |
$675.38
|
| Rate for Payer: Healthscope Whirlpool |
$675.38
|
| Rate for Payer: Meridian Medicaid |
$389.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$590.96
|
| Rate for Payer: PACE SWMI |
$562.82
|
| Rate for Payer: PHP Medicare Advantage |
$562.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$371.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,092.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$880.86
|
| Rate for Payer: Priority Health Medicare |
$562.82
|
| Rate for Payer: Priority Health Narrow Network |
$880.86
|
| Rate for Payer: UHC Medicare Advantage |
$579.70
|
|
|
PR AMP F/ARM THRU RADIUS&ULNA SEC CLOSURE/SCAR RE
|
Professional
|
Both
|
$1,584.00
|
|
|
Service Code
|
HCPCS 25907
|
| Min. Negotiated Rate |
$206.57 |
| Max. Negotiated Rate |
$1,108.80 |
| Rate for Payer: Aetna Commercial |
$813.85
|
| Rate for Payer: Aetna Medicare |
$607.35
|
| Rate for Payer: BCBS Complete |
$420.24
|
| Rate for Payer: BCBS MAPPO |
$607.35
|
| Rate for Payer: BCBS Trust/PPO |
$206.57
|
| Rate for Payer: BCN Commercial |
$908.45
|
| Rate for Payer: BCN Medicare Advantage |
$607.35
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cash Price |
$1,267.20
|
| Rate for Payer: Cofinity Commercial |
$874.58
|
| Rate for Payer: Cofinity Commercial |
$813.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.35
|
| Rate for Payer: Healthscope Commercial |
$728.82
|
| Rate for Payer: Healthscope Whirlpool |
$728.82
|
| Rate for Payer: Meridian Medicaid |
$420.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$637.72
|
| Rate for Payer: PACE SWMI |
$607.35
|
| Rate for Payer: PHP Medicare Advantage |
$607.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$400.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,108.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$949.29
|
| Rate for Payer: Priority Health Medicare |
$607.35
|
| Rate for Payer: Priority Health Narrow Network |
$949.29
|
| Rate for Payer: UHC Medicare Advantage |
$625.57
|
|
|
PR AMP FOREARM THRU RADIUS & ULNA OPEN CIRCULAR
|
Professional
|
Both
|
$1,882.00
|
|
|
Service Code
|
HCPCS 25905
|
| Min. Negotiated Rate |
$173.28 |
| Max. Negotiated Rate |
$1,317.40 |
| Rate for Payer: Aetna Commercial |
$929.38
|
| Rate for Payer: Aetna Medicare |
$693.57
|
| Rate for Payer: BCBS Complete |
$478.16
|
| Rate for Payer: BCBS MAPPO |
$693.57
|
| Rate for Payer: BCBS Trust/PPO |
$173.28
|
| Rate for Payer: BCN Commercial |
$1,035.02
|
| Rate for Payer: BCN Medicare Advantage |
$693.57
|
| Rate for Payer: Cash Price |
$1,505.60
|
| Rate for Payer: Cash Price |
$1,505.60
|
| Rate for Payer: Cofinity Commercial |
$929.38
|
| Rate for Payer: Cofinity Commercial |
$998.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$693.57
|
| Rate for Payer: Healthscope Commercial |
$832.28
|
| Rate for Payer: Healthscope Whirlpool |
$832.28
|
| Rate for Payer: Meridian Medicaid |
$478.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$728.25
|
| Rate for Payer: PACE SWMI |
$693.57
|
| Rate for Payer: PHP Medicare Advantage |
$693.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$455.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,317.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,081.56
|
| Rate for Payer: Priority Health Medicare |
$693.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,081.56
|
| Rate for Payer: UHC Medicare Advantage |
$714.38
|
|
