|
PR BIOPSY BONE OPEN SUPERFICIAL
|
Professional
|
Both
|
$535.00
|
|
|
Service Code
|
HCPCS 20240
|
| Min. Negotiated Rate |
$89.03 |
| Max. Negotiated Rate |
$1,002.07 |
| Rate for Payer: Aetna Commercial |
$183.98
|
| Rate for Payer: Aetna Medicare |
$137.30
|
| Rate for Payer: BCBS Complete |
$93.48
|
| Rate for Payer: BCBS MAPPO |
$137.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,002.07
|
| Rate for Payer: BCN Commercial |
$202.32
|
| Rate for Payer: BCN Medicare Advantage |
$137.30
|
| Rate for Payer: Cash Price |
$428.00
|
| Rate for Payer: Cash Price |
$428.00
|
| Rate for Payer: Cofinity Commercial |
$183.98
|
| Rate for Payer: Cofinity Commercial |
$197.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.30
|
| Rate for Payer: Healthscope Commercial |
$164.76
|
| Rate for Payer: Healthscope Whirlpool |
$164.76
|
| Rate for Payer: Meridian Medicaid |
$93.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$144.16
|
| Rate for Payer: PACE SWMI |
$137.30
|
| Rate for Payer: PHP Medicare Advantage |
$137.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$211.40
|
| Rate for Payer: Priority Health Medicare |
$137.30
|
| Rate for Payer: Priority Health Narrow Network |
$211.40
|
| Rate for Payer: UHC Medicare Advantage |
$141.42
|
|
|
PR BIOPSY BONE TROCAR/NEEDLE DEEP
|
Professional
|
Both
|
$1,880.00
|
|
|
Service Code
|
HCPCS 20225
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$1,316.00 |
| Rate for Payer: Aetna Commercial |
$169.39
|
| Rate for Payer: Aetna Medicare |
$126.41
|
| Rate for Payer: BCBS Complete |
$85.21
|
| Rate for Payer: BCBS MAPPO |
$126.41
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$567.36
|
| Rate for Payer: BCN Medicare Advantage |
$126.41
|
| Rate for Payer: Cash Price |
$1,504.00
|
| Rate for Payer: Cash Price |
$1,504.00
|
| Rate for Payer: Cofinity Commercial |
$182.03
|
| Rate for Payer: Cofinity Commercial |
$169.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.41
|
| Rate for Payer: Healthscope Commercial |
$151.69
|
| Rate for Payer: Healthscope Whirlpool |
$151.69
|
| Rate for Payer: Meridian Medicaid |
$85.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$132.73
|
| Rate for Payer: PACE SWMI |
$126.41
|
| Rate for Payer: PHP Medicare Advantage |
$126.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,316.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$194.56
|
| Rate for Payer: Priority Health Medicare |
$126.41
|
| Rate for Payer: Priority Health Narrow Network |
$194.56
|
| Rate for Payer: UHC Medicare Advantage |
$130.20
|
|
|
PR BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL
|
Professional
|
Both
|
$341.00
|
|
|
Service Code
|
HCPCS 20220
|
| Min. Negotiated Rate |
$54.74 |
| Max. Negotiated Rate |
$1,002.07 |
| Rate for Payer: Aetna Commercial |
$115.08
|
| Rate for Payer: Aetna Medicare |
$85.88
|
| Rate for Payer: BCBS Complete |
$57.48
|
| Rate for Payer: BCBS MAPPO |
$85.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,002.07
|
| Rate for Payer: BCN Commercial |
$346.47
|
| Rate for Payer: BCN Medicare Advantage |
$85.88
|
| Rate for Payer: Cash Price |
$272.80
|
| Rate for Payer: Cash Price |
$272.80
|
| Rate for Payer: Cofinity Commercial |
$123.67
|
| Rate for Payer: Cofinity Commercial |
$115.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.88
|
| Rate for Payer: Healthscope Commercial |
$103.06
|
| Rate for Payer: Healthscope Whirlpool |
$103.06
|
| Rate for Payer: Meridian Medicaid |
$57.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$90.17
|
| Rate for Payer: PACE SWMI |
$85.88
|
| Rate for Payer: PHP Medicare Advantage |
$85.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$132.26
|
| Rate for Payer: Priority Health Medicare |
$85.88
|
| Rate for Payer: Priority Health Narrow Network |
$132.26
|
| Rate for Payer: UHC Medicare Advantage |
$88.46
|
|
|
PR BIOPSY BREAST OPEN INCISIONAL
|
Professional
|
Both
|
$559.00
|
|
|
Service Code
|
HCPCS 19101
|
| Min. Negotiated Rate |
$8.65 |
| Max. Negotiated Rate |
$485.26 |
| Rate for Payer: Aetna Commercial |
$296.39
|
| Rate for Payer: Aetna Medicare |
$221.19
|
| Rate for Payer: BCBS Complete |
$150.74
|
| Rate for Payer: BCBS MAPPO |
$221.19
|
| Rate for Payer: BCBS Trust/PPO |
$8.65
|
| Rate for Payer: BCN Commercial |
$485.26
|
| Rate for Payer: BCN Medicare Advantage |
$221.19
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Cash Price |
$447.20
|
| Rate for Payer: Cofinity Commercial |
$296.39
|
| Rate for Payer: Cofinity Commercial |
$318.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.19
|
| Rate for Payer: Healthscope Commercial |
$265.43
|
| Rate for Payer: Healthscope Whirlpool |
$265.43
|
| Rate for Payer: Meridian Medicaid |
$150.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$232.25
|
| Rate for Payer: PACE SWMI |
$221.19
|
| Rate for Payer: PHP Medicare Advantage |
$221.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$391.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$275.80
|
| Rate for Payer: Priority Health Medicare |
$221.19
|
| Rate for Payer: Priority Health Narrow Network |
$275.80
|
| Rate for Payer: UHC Medicare Advantage |
$227.83
|
|
|
PR BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX
|
Professional
|
Both
|
$253.00
|
|
|
Service Code
|
HCPCS 57500
|
| Min. Negotiated Rate |
$48.14 |
| Max. Negotiated Rate |
$225.58 |
| Rate for Payer: Aetna Commercial |
$98.52
|
| Rate for Payer: Aetna Medicare |
$73.52
|
| Rate for Payer: BCBS Complete |
$50.55
|
| Rate for Payer: BCBS MAPPO |
$73.52
|
| Rate for Payer: BCBS Trust/PPO |
$225.58
|
| Rate for Payer: BCN Commercial |
$182.59
|
| Rate for Payer: BCN Medicare Advantage |
$73.52
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cofinity Commercial |
$98.52
|
| Rate for Payer: Cofinity Commercial |
$105.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.52
|
| Rate for Payer: Healthscope Commercial |
$88.22
|
| Rate for Payer: Healthscope Whirlpool |
$88.22
|
| Rate for Payer: Meridian Medicaid |
$50.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.20
|
| Rate for Payer: PACE SWMI |
$73.52
|
| Rate for Payer: PHP Medicare Advantage |
$73.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.58
|
| Rate for Payer: Priority Health Medicare |
$73.52
|
| Rate for Payer: Priority Health Narrow Network |
$105.58
|
| Rate for Payer: UHC Medicare Advantage |
$75.73
|
|
|
PR BIOPSY, EACH ADDED LESION
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 11101
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$46.90 |
| Rate for Payer: BCBS Complete |
$26.80
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.90
|
|
|
PR BIOPSY EXTERNAL AUDITORY CANAL
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 69105
|
| Min. Negotiated Rate |
$40.90 |
| Max. Negotiated Rate |
$2,308.67 |
| Rate for Payer: Aetna Commercial |
$82.93
|
| Rate for Payer: Aetna Medicare |
$61.89
|
| Rate for Payer: BCBS Complete |
$42.94
|
| Rate for Payer: BCBS MAPPO |
$61.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,308.67
|
| Rate for Payer: BCN Commercial |
$214.53
|
| Rate for Payer: BCN Medicare Advantage |
$61.89
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cofinity Commercial |
$89.12
|
| Rate for Payer: Cofinity Commercial |
$82.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.89
|
| Rate for Payer: Healthscope Commercial |
$74.27
|
| Rate for Payer: Healthscope Whirlpool |
$74.27
|
| Rate for Payer: Meridian Medicaid |
$42.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$64.98
|
| Rate for Payer: PACE SWMI |
$61.89
|
| Rate for Payer: PHP Medicare Advantage |
$61.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.58
|
| Rate for Payer: Priority Health Medicare |
$61.89
|
| Rate for Payer: Priority Health Narrow Network |
$89.58
|
| Rate for Payer: UHC Medicare Advantage |
$63.75
|
|
|
PR BIOPSY EXTERNAL EAR
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 69100
|
| Min. Negotiated Rate |
$29.39 |
| Max. Negotiated Rate |
$1,733.35 |
| Rate for Payer: Aetna Commercial |
$61.52
|
| Rate for Payer: Aetna Medicare |
$45.91
|
| Rate for Payer: BCBS Complete |
$30.86
|
| Rate for Payer: BCBS MAPPO |
$45.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,733.35
|
| Rate for Payer: BCN Commercial |
$141.72
|
| Rate for Payer: BCN Medicare Advantage |
$45.91
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cofinity Commercial |
$61.52
|
| Rate for Payer: Cofinity Commercial |
$66.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.91
|
| Rate for Payer: Healthscope Commercial |
$55.09
|
| Rate for Payer: Healthscope Whirlpool |
$55.09
|
| Rate for Payer: Meridian Medicaid |
$30.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$48.21
|
| Rate for Payer: PACE SWMI |
$45.91
|
| Rate for Payer: PHP Medicare Advantage |
$45.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.53
|
| Rate for Payer: Priority Health Medicare |
$45.91
|
| Rate for Payer: Priority Health Narrow Network |
$65.53
|
| Rate for Payer: UHC Medicare Advantage |
$47.29
|
|
|
PR BIOPSY FLOOR MOUTH
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 41108
|
| Min. Negotiated Rate |
$58.79 |
| Max. Negotiated Rate |
$1,421.66 |
| Rate for Payer: Aetna Commercial |
$119.47
|
| Rate for Payer: Aetna Medicare |
$89.16
|
| Rate for Payer: BCBS Complete |
$61.73
|
| Rate for Payer: BCBS MAPPO |
$89.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,421.66
|
| Rate for Payer: BCN Commercial |
$249.22
|
| Rate for Payer: BCN Medicare Advantage |
$89.16
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$119.47
|
| Rate for Payer: Cofinity Commercial |
$128.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.16
|
| Rate for Payer: Healthscope Commercial |
$106.99
|
| Rate for Payer: Healthscope Whirlpool |
$106.99
|
| Rate for Payer: Meridian Medicaid |
$61.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$93.62
|
| Rate for Payer: PACE SWMI |
$89.16
|
| Rate for Payer: PHP Medicare Advantage |
$89.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.69
|
| Rate for Payer: Priority Health Medicare |
$89.16
|
| Rate for Payer: Priority Health Narrow Network |
$161.69
|
| Rate for Payer: UHC Medicare Advantage |
$91.83
|
|
|
PR BIOPSY HYPOPHARYNX
|
Professional
|
Both
|
$432.00
|
|
|
Service Code
|
HCPCS 42802
|
| Min. Negotiated Rate |
$172.80 |
| Max. Negotiated Rate |
$302.40 |
| Rate for Payer: BCBS Complete |
$172.80
|
| Rate for Payer: Cash Price |
$345.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$302.40
|
|
|
PR BIOPSY INTRANASAL
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 30100
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$591.70 |
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.87
|
| Rate for Payer: Healthscope Commercial |
$79.04
|
| Rate for Payer: Healthscope Whirlpool |
$79.04
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.16
|
| Rate for Payer: PACE SWMI |
$65.87
|
| Rate for Payer: PHP Medicare Advantage |
$65.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.53
|
| Rate for Payer: Priority Health Medicare |
$65.87
|
| Rate for Payer: Priority Health Narrow Network |
$93.53
|
| Rate for Payer: UHC Medicare Advantage |
$67.85
|
| Rate for Payer: Aetna Commercial |
$88.27
|
| Rate for Payer: Aetna Medicare |
$65.87
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS MAPPO |
$65.87
|
| Rate for Payer: BCBS Trust/PPO |
$591.70
|
| Rate for Payer: BCN Commercial |
$208.66
|
| Rate for Payer: BCN Medicare Advantage |
$65.87
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$94.85
|
| Rate for Payer: Cofinity Commercial |
$88.27
|
|
|
PR BIOPSY LIVER NEEDLE PERCUTANEOUS
|
Professional
|
Both
|
$581.00
|
|
|
Service Code
|
HCPCS 47000
|
| Min. Negotiated Rate |
$54.95 |
| Max. Negotiated Rate |
$1,914.56 |
| Rate for Payer: Aetna Commercial |
$115.08
|
| Rate for Payer: Aetna Medicare |
$85.88
|
| Rate for Payer: BCBS Complete |
$57.70
|
| Rate for Payer: BCBS MAPPO |
$85.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,914.56
|
| Rate for Payer: BCN Commercial |
$489.65
|
| Rate for Payer: BCN Medicare Advantage |
$85.88
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Cash Price |
$464.80
|
| Rate for Payer: Cofinity Commercial |
$115.08
|
| Rate for Payer: Cofinity Commercial |
$123.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.88
|
| Rate for Payer: Healthscope Commercial |
$103.06
|
| Rate for Payer: Healthscope Whirlpool |
$103.06
|
| Rate for Payer: Meridian Medicaid |
$57.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$90.17
|
| Rate for Payer: PACE SWMI |
$85.88
|
| Rate for Payer: PHP Medicare Advantage |
$85.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$406.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$152.29
|
| Rate for Payer: Priority Health Medicare |
$85.88
|
| Rate for Payer: Priority Health Narrow Network |
$152.29
|
| Rate for Payer: UHC Medicare Advantage |
$88.46
|
|
|
PR BIOPSY LIVER WEDGE
|
Professional
|
Both
|
$1,754.00
|
|
|
Service Code
|
HCPCS 47100
|
| Min. Negotiated Rate |
$545.07 |
| Max. Negotiated Rate |
$2,085.20 |
| Rate for Payer: Aetna Commercial |
$1,126.62
|
| Rate for Payer: Aetna Medicare |
$840.76
|
| Rate for Payer: BCBS Complete |
$572.32
|
| Rate for Payer: BCBS MAPPO |
$840.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,085.20
|
| Rate for Payer: BCN Commercial |
$1,241.73
|
| Rate for Payer: BCN Medicare Advantage |
$840.76
|
| Rate for Payer: Cash Price |
$1,403.20
|
| Rate for Payer: Cash Price |
$1,403.20
|
| Rate for Payer: Cofinity Commercial |
$1,210.69
|
| Rate for Payer: Cofinity Commercial |
$1,126.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$840.76
|
| Rate for Payer: Healthscope Commercial |
$1,008.91
|
| Rate for Payer: Healthscope Whirlpool |
$1,008.91
|
| Rate for Payer: Meridian Medicaid |
$572.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$882.80
|
| Rate for Payer: PACE SWMI |
$840.76
|
| Rate for Payer: PHP Medicare Advantage |
$840.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$545.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,227.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,494.03
|
| Rate for Payer: Priority Health Medicare |
$840.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,494.03
|
| Rate for Payer: UHC Medicare Advantage |
$865.98
|
|
|
PR BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$747.00
|
|
|
Service Code
|
HCPCS 32405
|
| Min. Negotiated Rate |
$298.80 |
| Max. Negotiated Rate |
$522.90 |
| Rate for Payer: BCBS Complete |
$298.80
|
| Rate for Payer: Cash Price |
$597.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$522.90
|
|
|
PR BIOPSY MUSCLE DEEP
|
Professional
|
Both
|
$579.00
|
|
|
Service Code
|
HCPCS 20205
|
| Min. Negotiated Rate |
$99.26 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: Aetna Commercial |
$205.07
|
| Rate for Payer: Aetna Medicare |
$153.04
|
| Rate for Payer: BCBS Complete |
$104.22
|
| Rate for Payer: BCBS MAPPO |
$153.04
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$447.63
|
| Rate for Payer: BCN Medicare Advantage |
$153.04
|
| Rate for Payer: Cash Price |
$463.20
|
| Rate for Payer: Cash Price |
$463.20
|
| Rate for Payer: Cofinity Commercial |
$220.38
|
| Rate for Payer: Cofinity Commercial |
$205.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.04
|
| Rate for Payer: Healthscope Commercial |
$183.65
|
| Rate for Payer: Healthscope Whirlpool |
$183.65
|
| Rate for Payer: Meridian Medicaid |
$104.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$160.69
|
| Rate for Payer: PACE SWMI |
$153.04
|
| Rate for Payer: PHP Medicare Advantage |
$153.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$405.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$235.41
|
| Rate for Payer: Priority Health Medicare |
$153.04
|
| Rate for Payer: Priority Health Narrow Network |
$235.41
|
| Rate for Payer: UHC Medicare Advantage |
$157.63
|
|
|
PR BIOPSY MUSCLE PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$406.00
|
|
|
Service Code
|
HCPCS 20206
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$2,284.30 |
| Rate for Payer: Aetna Commercial |
$74.66
|
| Rate for Payer: Aetna Medicare |
$55.72
|
| Rate for Payer: BCBS Complete |
$37.80
|
| Rate for Payer: BCBS MAPPO |
$55.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,284.30
|
| Rate for Payer: BCN Commercial |
$329.36
|
| Rate for Payer: BCN Medicare Advantage |
$55.72
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cofinity Commercial |
$74.66
|
| Rate for Payer: Cofinity Commercial |
$80.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.72
|
| Rate for Payer: Healthscope Commercial |
$66.86
|
| Rate for Payer: Healthscope Whirlpool |
$66.86
|
| Rate for Payer: Meridian Medicaid |
$37.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$58.51
|
| Rate for Payer: PACE SWMI |
$55.72
|
| Rate for Payer: PHP Medicare Advantage |
$55.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.30
|
| Rate for Payer: Priority Health Medicare |
$55.72
|
| Rate for Payer: Priority Health Narrow Network |
$86.30
|
| Rate for Payer: UHC Medicare Advantage |
$57.39
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Facility
|
OP
|
$352.00
|
|
|
Service Code
|
CPT 20200
|
| Hospital Charge Code |
20200
|
| Min. Negotiated Rate |
$246.40 |
| Max. Negotiated Rate |
$1,801.41 |
| Rate for Payer: Aetna Commercial |
$316.80
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$341.44
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$272.91
|
| Rate for Payer: BCN Commercial |
$272.91
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cofinity Commercial |
$330.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$352.00
|
| Rate for Payer: Healthscope Whirlpool |
$341.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$316.80
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$299.20
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.32
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$249.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$309.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Professional
|
Both
|
$352.00
|
|
|
Service Code
|
HCPCS 20200
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$672.75 |
| Rate for Payer: Aetna Commercial |
$125.75
|
| Rate for Payer: Aetna Medicare |
$93.84
|
| Rate for Payer: BCBS Complete |
$63.97
|
| Rate for Payer: BCBS MAPPO |
$93.84
|
| Rate for Payer: BCBS Trust/PPO |
$672.75
|
| Rate for Payer: BCN Commercial |
$321.06
|
| Rate for Payer: BCN Medicare Advantage |
$93.84
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cofinity Commercial |
$125.75
|
| Rate for Payer: Cofinity Commercial |
$135.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$112.61
|
| Rate for Payer: Healthscope Whirlpool |
$112.61
|
| Rate for Payer: Meridian Medicaid |
$63.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.53
|
| Rate for Payer: PACE SWMI |
$93.84
|
| Rate for Payer: PHP Medicare Advantage |
$93.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.51
|
| Rate for Payer: Priority Health Medicare |
$93.84
|
| Rate for Payer: Priority Health Narrow Network |
$144.51
|
| Rate for Payer: UHC Medicare Advantage |
$96.66
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Professional
|
Both
|
$352.00
|
|
|
Service Code
|
HCPCS 20200
|
| Hospital Charge Code |
20200
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$672.75 |
| Rate for Payer: Aetna Commercial |
$125.75
|
| Rate for Payer: Aetna Medicare |
$93.84
|
| Rate for Payer: BCBS Complete |
$63.97
|
| Rate for Payer: BCBS MAPPO |
$93.84
|
| Rate for Payer: BCBS Trust/PPO |
$672.75
|
| Rate for Payer: BCN Commercial |
$321.06
|
| Rate for Payer: BCN Medicare Advantage |
$93.84
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cofinity Commercial |
$135.13
|
| Rate for Payer: Cofinity Commercial |
$125.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$112.61
|
| Rate for Payer: Healthscope Whirlpool |
$112.61
|
| Rate for Payer: Meridian Medicaid |
$63.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.53
|
| Rate for Payer: PACE SWMI |
$93.84
|
| Rate for Payer: PHP Medicare Advantage |
$93.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.51
|
| Rate for Payer: Priority Health Medicare |
$93.84
|
| Rate for Payer: Priority Health Narrow Network |
$144.51
|
| Rate for Payer: UHC Medicare Advantage |
$96.66
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Facility
|
IP
|
$352.00
|
|
|
Service Code
|
CPT 20200
|
| Hospital Charge Code |
20200
|
| Min. Negotiated Rate |
$246.40 |
| Max. Negotiated Rate |
$352.00 |
| Rate for Payer: Aetna Commercial |
$316.80
|
| Rate for Payer: ASR ASR |
$341.44
|
| Rate for Payer: BCBS Trust/PPO |
$272.91
|
| Rate for Payer: BCN Commercial |
$272.91
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cofinity Commercial |
$330.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.60
|
| Rate for Payer: Healthscope Commercial |
$352.00
|
| Rate for Payer: Healthscope Whirlpool |
$341.44
|
| Rate for Payer: Mclaren Commercial |
$316.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$299.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$309.76
|
|
|
PR BIOPSY NAIL UNIT SEPARATE PROCEDURE
|
Professional
|
Both
|
$217.00
|
|
|
Service Code
|
HCPCS 11755
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$151.90 |
| Rate for Payer: Aetna Commercial |
$79.85
|
| Rate for Payer: Aetna Medicare |
$59.59
|
| Rate for Payer: BCBS Complete |
$40.26
|
| Rate for Payer: BCBS MAPPO |
$59.59
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$144.11
|
| Rate for Payer: BCN Medicare Advantage |
$59.59
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cofinity Commercial |
$85.81
|
| Rate for Payer: Cofinity Commercial |
$79.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.59
|
| Rate for Payer: Healthscope Commercial |
$71.51
|
| Rate for Payer: Healthscope Whirlpool |
$71.51
|
| Rate for Payer: Meridian Medicaid |
$40.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$62.57
|
| Rate for Payer: PACE SWMI |
$59.59
|
| Rate for Payer: PHP Medicare Advantage |
$59.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.58
|
| Rate for Payer: Priority Health Medicare |
$59.59
|
| Rate for Payer: Priority Health Narrow Network |
$73.58
|
| Rate for Payer: UHC Medicare Advantage |
$61.38
|
|
|
PR BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE
|
Professional
|
Both
|
$822.00
|
|
|
Service Code
|
HCPCS 42804
|
| Min. Negotiated Rate |
$79.66 |
| Max. Negotiated Rate |
$575.40 |
| Rate for Payer: Aetna Commercial |
$159.70
|
| Rate for Payer: Aetna Medicare |
$119.18
|
| Rate for Payer: BCBS Complete |
$83.64
|
| Rate for Payer: BCBS MAPPO |
$119.18
|
| Rate for Payer: BCBS Trust/PPO |
$212.38
|
| Rate for Payer: BCN Commercial |
$319.11
|
| Rate for Payer: BCN Medicare Advantage |
$119.18
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cofinity Commercial |
$171.62
|
| Rate for Payer: Cofinity Commercial |
$159.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.18
|
| Rate for Payer: Healthscope Commercial |
$143.02
|
| Rate for Payer: Healthscope Whirlpool |
$143.02
|
| Rate for Payer: Meridian Medicaid |
$83.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$125.14
|
| Rate for Payer: PACE SWMI |
$119.18
|
| Rate for Payer: PHP Medicare Advantage |
$119.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.55
|
| Rate for Payer: Priority Health Medicare |
$119.18
|
| Rate for Payer: Priority Health Narrow Network |
$217.55
|
| Rate for Payer: UHC Medicare Advantage |
$122.76
|
|
|
PR BIOPSY NERVE
|
Professional
|
Both
|
$708.00
|
|
|
Service Code
|
HCPCS 64795
|
| Min. Negotiated Rate |
$124.82 |
| Max. Negotiated Rate |
$495.60 |
| Rate for Payer: Aetna Commercial |
$257.27
|
| Rate for Payer: Aetna Medicare |
$191.99
|
| Rate for Payer: BCBS Complete |
$131.06
|
| Rate for Payer: BCBS MAPPO |
$191.99
|
| Rate for Payer: BCBS Trust/PPO |
$218.19
|
| Rate for Payer: BCN Commercial |
$282.46
|
| Rate for Payer: BCN Medicare Advantage |
$191.99
|
| Rate for Payer: Cash Price |
$566.40
|
| Rate for Payer: Cash Price |
$566.40
|
| Rate for Payer: Cofinity Commercial |
$276.47
|
| Rate for Payer: Cofinity Commercial |
$257.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.99
|
| Rate for Payer: Healthscope Commercial |
$230.39
|
| Rate for Payer: Healthscope Whirlpool |
$230.39
|
| Rate for Payer: Meridian Medicaid |
$131.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$201.59
|
| Rate for Payer: PACE SWMI |
$191.99
|
| Rate for Payer: PHP Medicare Advantage |
$191.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$495.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.28
|
| Rate for Payer: Priority Health Medicare |
$191.99
|
| Rate for Payer: Priority Health Narrow Network |
$327.28
|
| Rate for Payer: UHC Medicare Advantage |
$197.75
|
|
|
PR BIOPSY OF LIP
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 40490
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$637.13 |
| Rate for Payer: Aetna Commercial |
$90.64
|
| Rate for Payer: Aetna Medicare |
$67.64
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS MAPPO |
$67.64
|
| Rate for Payer: BCBS Trust/PPO |
$637.13
|
| Rate for Payer: BCN Commercial |
$144.50
|
| Rate for Payer: BCN Medicare Advantage |
$67.64
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$90.64
|
| Rate for Payer: Cofinity Commercial |
$97.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.64
|
| Rate for Payer: Healthscope Commercial |
$81.17
|
| Rate for Payer: Healthscope Whirlpool |
$81.17
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$71.02
|
| Rate for Payer: PACE SWMI |
$67.64
|
| Rate for Payer: PHP Medicare Advantage |
$67.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.54
|
| Rate for Payer: Priority Health Medicare |
$67.64
|
| Rate for Payer: Priority Health Narrow Network |
$120.54
|
| Rate for Payer: UHC Medicare Advantage |
$69.67
|
|
|
PR BIOPSY OF SKIN LESION
|
Professional
|
Both
|
$168.00
|
|
|
Service Code
|
HCPCS 11100
|
| Min. Negotiated Rate |
$67.20 |
| Max. Negotiated Rate |
$117.60 |
| Rate for Payer: BCBS Complete |
$67.20
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.60
|
|
