|
PR BIOPSY OROPHARYNX
|
Professional
|
Both
|
$253.00
|
|
|
Service Code
|
HCPCS 42800
|
| Min. Negotiated Rate |
$75.62 |
| Max. Negotiated Rate |
$233.59 |
| Rate for Payer: Aetna Commercial |
$152.10
|
| Rate for Payer: Aetna Medicare |
$113.51
|
| Rate for Payer: BCBS Complete |
$79.40
|
| Rate for Payer: BCBS MAPPO |
$113.51
|
| Rate for Payer: BCBS Trust/PPO |
$175.40
|
| Rate for Payer: BCN Commercial |
$233.59
|
| Rate for Payer: BCN Medicare Advantage |
$113.51
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cofinity Commercial |
$152.10
|
| Rate for Payer: Cofinity Commercial |
$163.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.51
|
| Rate for Payer: Healthscope Commercial |
$136.21
|
| Rate for Payer: Healthscope Whirlpool |
$136.21
|
| Rate for Payer: Meridian Medicaid |
$79.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.19
|
| Rate for Payer: PACE SWMI |
$113.51
|
| Rate for Payer: PHP Medicare Advantage |
$113.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.80
|
| Rate for Payer: Priority Health Medicare |
$113.51
|
| Rate for Payer: Priority Health Narrow Network |
$205.80
|
| Rate for Payer: UHC Medicare Advantage |
$116.92
|
|
|
PR BIOPSY OVARY UNI/BI SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,585.00
|
|
|
Service Code
|
HCPCS 58900
|
| Min. Negotiated Rate |
$170.11 |
| Max. Negotiated Rate |
$1,109.50 |
| Rate for Payer: Aetna Commercial |
$580.51
|
| Rate for Payer: Aetna Medicare |
$433.22
|
| Rate for Payer: BCBS Complete |
$296.34
|
| Rate for Payer: BCBS MAPPO |
$433.22
|
| Rate for Payer: BCBS Trust/PPO |
$170.11
|
| Rate for Payer: BCN Commercial |
$644.57
|
| Rate for Payer: BCN Medicare Advantage |
$433.22
|
| Rate for Payer: Cash Price |
$1,268.00
|
| Rate for Payer: Cash Price |
$1,268.00
|
| Rate for Payer: Cofinity Commercial |
$623.84
|
| Rate for Payer: Cofinity Commercial |
$580.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$433.22
|
| Rate for Payer: Healthscope Commercial |
$519.86
|
| Rate for Payer: Healthscope Whirlpool |
$519.86
|
| Rate for Payer: Meridian Medicaid |
$296.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$454.88
|
| Rate for Payer: PACE SWMI |
$433.22
|
| Rate for Payer: PHP Medicare Advantage |
$433.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$282.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,109.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$624.44
|
| Rate for Payer: Priority Health Medicare |
$433.22
|
| Rate for Payer: Priority Health Narrow Network |
$624.44
|
| Rate for Payer: UHC Medicare Advantage |
$446.22
|
|
|
PR BIOPSY PALATE UVULA
|
Professional
|
Both
|
$263.00
|
|
|
Service Code
|
HCPCS 42100
|
| Min. Negotiated Rate |
$70.93 |
| Max. Negotiated Rate |
$796.68 |
| Rate for Payer: Aetna Commercial |
$143.35
|
| Rate for Payer: Aetna Medicare |
$106.98
|
| Rate for Payer: BCBS Complete |
$74.48
|
| Rate for Payer: BCBS MAPPO |
$106.98
|
| Rate for Payer: BCBS Trust/PPO |
$796.68
|
| Rate for Payer: BCN Commercial |
$216.00
|
| Rate for Payer: BCN Medicare Advantage |
$106.98
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$154.05
|
| Rate for Payer: Cofinity Commercial |
$143.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.98
|
| Rate for Payer: Healthscope Commercial |
$128.38
|
| Rate for Payer: Healthscope Whirlpool |
$128.38
|
| Rate for Payer: Meridian Medicaid |
$74.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$112.33
|
| Rate for Payer: PACE SWMI |
$106.98
|
| Rate for Payer: PHP Medicare Advantage |
$106.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$194.03
|
| Rate for Payer: Priority Health Medicare |
$106.98
|
| Rate for Payer: Priority Health Narrow Network |
$194.03
|
| Rate for Payer: UHC Medicare Advantage |
$110.19
|
|
|
PR BIOPSY PANCREAS OPEN
|
Professional
|
Both
|
$1,557.00
|
|
|
Service Code
|
HCPCS 48100
|
| Min. Negotiated Rate |
$571.48 |
| Max. Negotiated Rate |
$2,117.43 |
| Rate for Payer: Aetna Commercial |
$1,182.11
|
| Rate for Payer: Aetna Medicare |
$882.17
|
| Rate for Payer: BCBS Complete |
$600.05
|
| Rate for Payer: BCBS MAPPO |
$882.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,117.43
|
| Rate for Payer: BCN Commercial |
$1,296.95
|
| Rate for Payer: BCN Medicare Advantage |
$882.17
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cash Price |
$1,245.60
|
| Rate for Payer: Cofinity Commercial |
$1,182.11
|
| Rate for Payer: Cofinity Commercial |
$1,270.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$882.17
|
| Rate for Payer: Healthscope Commercial |
$1,058.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,058.60
|
| Rate for Payer: Meridian Medicaid |
$600.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$926.28
|
| Rate for Payer: PACE SWMI |
$882.17
|
| Rate for Payer: PHP Medicare Advantage |
$882.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$571.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,089.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,560.49
|
| Rate for Payer: Priority Health Medicare |
$882.17
|
| Rate for Payer: Priority Health Narrow Network |
$1,560.49
|
| Rate for Payer: UHC Medicare Advantage |
$908.64
|
|
|
PR BIOPSY PENIS DEEP STRUCTURES
|
Professional
|
Both
|
$552.00
|
|
|
Service Code
|
HCPCS 54105
|
| Min. Negotiated Rate |
$136.11 |
| Max. Negotiated Rate |
$1,906.11 |
| Rate for Payer: Aetna Commercial |
$277.65
|
| Rate for Payer: Aetna Medicare |
$207.20
|
| Rate for Payer: BCBS Complete |
$142.92
|
| Rate for Payer: BCBS MAPPO |
$207.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,906.11
|
| Rate for Payer: BCN Commercial |
$401.69
|
| Rate for Payer: BCN Medicare Advantage |
$207.20
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cofinity Commercial |
$298.37
|
| Rate for Payer: Cofinity Commercial |
$277.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.20
|
| Rate for Payer: Healthscope Commercial |
$248.64
|
| Rate for Payer: Healthscope Whirlpool |
$248.64
|
| Rate for Payer: Meridian Medicaid |
$142.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$217.56
|
| Rate for Payer: PACE SWMI |
$207.20
|
| Rate for Payer: PHP Medicare Advantage |
$207.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$339.88
|
| Rate for Payer: Priority Health Medicare |
$207.20
|
| Rate for Payer: Priority Health Narrow Network |
$339.88
|
| Rate for Payer: UHC Medicare Advantage |
$213.42
|
|
|
PR BIOPSY PENIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$301.00
|
|
|
Service Code
|
HCPCS 54100
|
| Min. Negotiated Rate |
$77.32 |
| Max. Negotiated Rate |
$1,453.88 |
| Rate for Payer: Aetna Commercial |
$157.28
|
| Rate for Payer: Aetna Medicare |
$117.37
|
| Rate for Payer: BCBS Complete |
$81.19
|
| Rate for Payer: BCBS MAPPO |
$117.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.88
|
| Rate for Payer: BCN Commercial |
$296.14
|
| Rate for Payer: BCN Medicare Advantage |
$117.37
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cofinity Commercial |
$169.01
|
| Rate for Payer: Cofinity Commercial |
$157.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.37
|
| Rate for Payer: Healthscope Commercial |
$140.84
|
| Rate for Payer: Healthscope Whirlpool |
$140.84
|
| Rate for Payer: Meridian Medicaid |
$81.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$123.24
|
| Rate for Payer: PACE SWMI |
$117.37
|
| Rate for Payer: PHP Medicare Advantage |
$117.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.45
|
| Rate for Payer: Priority Health Medicare |
$117.37
|
| Rate for Payer: Priority Health Narrow Network |
$193.45
|
| Rate for Payer: UHC Medicare Advantage |
$120.89
|
|
|
PR BIOPSY PROSTATE INCISIONAL ANY APPROACH
|
Professional
|
Both
|
$468.00
|
|
|
Service Code
|
HCPCS 55705
|
| Min. Negotiated Rate |
$168.70 |
| Max. Negotiated Rate |
$1,436.98 |
| Rate for Payer: Aetna Commercial |
$346.66
|
| Rate for Payer: Aetna Medicare |
$258.70
|
| Rate for Payer: BCBS Complete |
$177.14
|
| Rate for Payer: BCBS MAPPO |
$258.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,436.98
|
| Rate for Payer: BCN Commercial |
$382.64
|
| Rate for Payer: BCN Medicare Advantage |
$258.70
|
| Rate for Payer: Cash Price |
$374.40
|
| Rate for Payer: Cash Price |
$374.40
|
| Rate for Payer: Cofinity Commercial |
$372.53
|
| Rate for Payer: Cofinity Commercial |
$346.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$258.70
|
| Rate for Payer: Healthscope Commercial |
$310.44
|
| Rate for Payer: Healthscope Whirlpool |
$310.44
|
| Rate for Payer: Meridian Medicaid |
$177.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$271.64
|
| Rate for Payer: PACE SWMI |
$258.70
|
| Rate for Payer: PHP Medicare Advantage |
$258.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$327.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$423.11
|
| Rate for Payer: Priority Health Medicare |
$258.70
|
| Rate for Payer: Priority Health Narrow Network |
$423.11
|
| Rate for Payer: UHC Medicare Advantage |
$266.46
|
|
|
PR BIOPSY SALIVARY GLAND INCISIONAL
|
Professional
|
Both
|
$523.00
|
|
|
Service Code
|
HCPCS 42405
|
| Min. Negotiated Rate |
$146.12 |
| Max. Negotiated Rate |
$448.61 |
| Rate for Payer: Aetna Commercial |
$298.66
|
| Rate for Payer: Aetna Medicare |
$222.88
|
| Rate for Payer: BCBS Complete |
$153.43
|
| Rate for Payer: BCBS MAPPO |
$222.88
|
| Rate for Payer: BCBS Trust/PPO |
$192.83
|
| Rate for Payer: BCN Commercial |
$448.61
|
| Rate for Payer: BCN Medicare Advantage |
$222.88
|
| Rate for Payer: Cash Price |
$418.40
|
| Rate for Payer: Cash Price |
$418.40
|
| Rate for Payer: Cofinity Commercial |
$320.95
|
| Rate for Payer: Cofinity Commercial |
$298.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.88
|
| Rate for Payer: Healthscope Commercial |
$267.46
|
| Rate for Payer: Healthscope Whirlpool |
$267.46
|
| Rate for Payer: Meridian Medicaid |
$153.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$234.02
|
| Rate for Payer: PACE SWMI |
$222.88
|
| Rate for Payer: PHP Medicare Advantage |
$222.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$366.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$400.41
|
| Rate for Payer: Priority Health Medicare |
$222.88
|
| Rate for Payer: Priority Health Narrow Network |
$400.41
|
| Rate for Payer: UHC Medicare Advantage |
$229.57
|
|
|
PR BIOPSY SOFT TISSUE BACK/FLANK DEEP
|
Professional
|
Both
|
$902.00
|
|
|
Service Code
|
HCPCS 21925
|
| Min. Negotiated Rate |
$245.59 |
| Max. Negotiated Rate |
$727.15 |
| Rate for Payer: Aetna Commercial |
$495.99
|
| Rate for Payer: Aetna Medicare |
$370.14
|
| Rate for Payer: BCBS Complete |
$257.87
|
| Rate for Payer: BCBS MAPPO |
$370.14
|
| Rate for Payer: BCBS Trust/PPO |
$280.06
|
| Rate for Payer: BCN Commercial |
$727.15
|
| Rate for Payer: BCN Medicare Advantage |
$370.14
|
| Rate for Payer: Cash Price |
$721.60
|
| Rate for Payer: Cash Price |
$721.60
|
| Rate for Payer: Cofinity Commercial |
$495.99
|
| Rate for Payer: Cofinity Commercial |
$533.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$370.14
|
| Rate for Payer: Healthscope Commercial |
$444.17
|
| Rate for Payer: Healthscope Whirlpool |
$444.17
|
| Rate for Payer: Meridian Medicaid |
$257.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$388.65
|
| Rate for Payer: PACE SWMI |
$370.14
|
| Rate for Payer: PHP Medicare Advantage |
$370.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$245.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$580.10
|
| Rate for Payer: Priority Health Medicare |
$370.14
|
| Rate for Payer: Priority Health Narrow Network |
$580.10
|
| Rate for Payer: UHC Medicare Advantage |
$381.24
|
|
|
PR BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL
|
Professional
|
Both
|
$498.00
|
|
|
Service Code
|
HCPCS 21920
|
| Min. Negotiated Rate |
$99.47 |
| Max. Negotiated Rate |
$625.34 |
| Rate for Payer: Aetna Commercial |
$202.30
|
| Rate for Payer: Aetna Medicare |
$150.97
|
| Rate for Payer: BCBS Complete |
$104.44
|
| Rate for Payer: BCBS MAPPO |
$150.97
|
| Rate for Payer: BCBS Trust/PPO |
$625.34
|
| Rate for Payer: BCN Commercial |
$377.26
|
| Rate for Payer: BCN Medicare Advantage |
$150.97
|
| Rate for Payer: Cash Price |
$398.40
|
| Rate for Payer: Cash Price |
$398.40
|
| Rate for Payer: Cofinity Commercial |
$217.40
|
| Rate for Payer: Cofinity Commercial |
$202.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.97
|
| Rate for Payer: Healthscope Commercial |
$181.16
|
| Rate for Payer: Healthscope Whirlpool |
$181.16
|
| Rate for Payer: Meridian Medicaid |
$104.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$158.52
|
| Rate for Payer: PACE SWMI |
$150.97
|
| Rate for Payer: PHP Medicare Advantage |
$150.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.43
|
| Rate for Payer: Priority Health Medicare |
$150.97
|
| Rate for Payer: Priority Health Narrow Network |
$236.43
|
| Rate for Payer: UHC Medicare Advantage |
$155.50
|
|
|
PR BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP
|
Professional
|
Both
|
$822.00
|
|
|
Service Code
|
HCPCS 25066
|
| Min. Negotiated Rate |
$240.26 |
| Max. Negotiated Rate |
$1,010.64 |
| Rate for Payer: Aetna Commercial |
$484.65
|
| Rate for Payer: Aetna Medicare |
$361.68
|
| Rate for Payer: BCBS Complete |
$252.27
|
| Rate for Payer: BCBS MAPPO |
$361.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,010.64
|
| Rate for Payer: BCN Commercial |
$544.87
|
| Rate for Payer: BCN Medicare Advantage |
$361.68
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cofinity Commercial |
$520.82
|
| Rate for Payer: Cofinity Commercial |
$484.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$361.68
|
| Rate for Payer: Healthscope Commercial |
$434.02
|
| Rate for Payer: Healthscope Whirlpool |
$434.02
|
| Rate for Payer: Meridian Medicaid |
$252.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$379.76
|
| Rate for Payer: PACE SWMI |
$361.68
|
| Rate for Payer: PHP Medicare Advantage |
$361.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$569.37
|
| Rate for Payer: Priority Health Medicare |
$361.68
|
| Rate for Payer: Priority Health Narrow Network |
$569.37
|
| Rate for Payer: UHC Medicare Advantage |
$372.53
|
|
|
PR BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL
|
Professional
|
Both
|
$477.00
|
|
|
Service Code
|
HCPCS 25065
|
| Min. Negotiated Rate |
$101.81 |
| Max. Negotiated Rate |
$376.28 |
| Rate for Payer: Aetna Commercial |
$206.09
|
| Rate for Payer: Aetna Medicare |
$153.80
|
| Rate for Payer: BCBS Complete |
$106.90
|
| Rate for Payer: BCBS MAPPO |
$153.80
|
| Rate for Payer: BCBS Trust/PPO |
$140.53
|
| Rate for Payer: BCN Commercial |
$376.28
|
| Rate for Payer: BCN Medicare Advantage |
$153.80
|
| Rate for Payer: Cash Price |
$381.60
|
| Rate for Payer: Cash Price |
$381.60
|
| Rate for Payer: Cofinity Commercial |
$221.47
|
| Rate for Payer: Cofinity Commercial |
$206.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.80
|
| Rate for Payer: Healthscope Commercial |
$184.56
|
| Rate for Payer: Healthscope Whirlpool |
$184.56
|
| Rate for Payer: Meridian Medicaid |
$106.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$161.49
|
| Rate for Payer: PACE SWMI |
$153.80
|
| Rate for Payer: PHP Medicare Advantage |
$153.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$241.54
|
| Rate for Payer: Priority Health Medicare |
$153.80
|
| Rate for Payer: Priority Health Narrow Network |
$241.54
|
| Rate for Payer: UHC Medicare Advantage |
$158.41
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP
|
Professional
|
Both
|
$925.00
|
|
|
Service Code
|
HCPCS 27614
|
| Min. Negotiated Rate |
$269.02 |
| Max. Negotiated Rate |
$1,061.35 |
| Rate for Payer: Aetna Commercial |
$548.22
|
| Rate for Payer: Aetna Medicare |
$409.12
|
| Rate for Payer: BCBS Complete |
$282.47
|
| Rate for Payer: BCBS MAPPO |
$409.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,061.35
|
| Rate for Payer: BCN Commercial |
$865.94
|
| Rate for Payer: BCN Medicare Advantage |
$409.12
|
| Rate for Payer: Cash Price |
$740.00
|
| Rate for Payer: Cash Price |
$740.00
|
| Rate for Payer: Cofinity Commercial |
$589.13
|
| Rate for Payer: Cofinity Commercial |
$548.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.12
|
| Rate for Payer: Healthscope Commercial |
$490.94
|
| Rate for Payer: Healthscope Whirlpool |
$490.94
|
| Rate for Payer: Meridian Medicaid |
$282.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$429.58
|
| Rate for Payer: PACE SWMI |
$409.12
|
| Rate for Payer: PHP Medicare Advantage |
$409.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$647.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$638.82
|
| Rate for Payer: Priority Health Medicare |
$409.12
|
| Rate for Payer: Priority Health Narrow Network |
$638.82
|
| Rate for Payer: UHC Medicare Advantage |
$421.39
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL
|
Professional
|
Both
|
$437.00
|
|
|
Service Code
|
HCPCS 27613
|
| Min. Negotiated Rate |
$104.16 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$209.78
|
| Rate for Payer: Aetna Medicare |
$156.55
|
| Rate for Payer: BCBS Complete |
$109.37
|
| Rate for Payer: BCBS MAPPO |
$156.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: BCN Commercial |
$369.44
|
| Rate for Payer: BCN Medicare Advantage |
$156.55
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cofinity Commercial |
$209.78
|
| Rate for Payer: Cofinity Commercial |
$225.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.55
|
| Rate for Payer: Healthscope Commercial |
$187.86
|
| Rate for Payer: Healthscope Whirlpool |
$187.86
|
| Rate for Payer: Meridian Medicaid |
$109.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$164.38
|
| Rate for Payer: PACE SWMI |
$156.55
|
| Rate for Payer: PHP Medicare Advantage |
$156.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$245.11
|
| Rate for Payer: Priority Health Medicare |
$156.55
|
| Rate for Payer: Priority Health Narrow Network |
$245.11
|
| Rate for Payer: UHC Medicare Advantage |
$161.25
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL
|
Professional
|
Both
|
$437.00
|
|
|
Service Code
|
HCPCS 27613
|
| Hospital Charge Code |
27613
|
| Min. Negotiated Rate |
$104.16 |
| Max. Negotiated Rate |
$2,976.66 |
| Rate for Payer: Aetna Commercial |
$209.78
|
| Rate for Payer: Aetna Medicare |
$156.55
|
| Rate for Payer: BCBS Complete |
$109.37
|
| Rate for Payer: BCBS MAPPO |
$156.55
|
| Rate for Payer: BCBS Trust/PPO |
$2,976.66
|
| Rate for Payer: BCN Commercial |
$369.44
|
| Rate for Payer: BCN Medicare Advantage |
$156.55
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cofinity Commercial |
$225.43
|
| Rate for Payer: Cofinity Commercial |
$209.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.55
|
| Rate for Payer: Healthscope Commercial |
$187.86
|
| Rate for Payer: Healthscope Whirlpool |
$187.86
|
| Rate for Payer: Meridian Medicaid |
$109.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$164.38
|
| Rate for Payer: PACE SWMI |
$156.55
|
| Rate for Payer: PHP Medicare Advantage |
$156.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$245.11
|
| Rate for Payer: Priority Health Medicare |
$156.55
|
| Rate for Payer: Priority Health Narrow Network |
$245.11
|
| Rate for Payer: UHC Medicare Advantage |
$161.25
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL
|
Facility
|
OP
|
$437.00
|
|
|
Service Code
|
CPT 27613
|
| Hospital Charge Code |
27613
|
| Min. Negotiated Rate |
$305.90 |
| Max. Negotiated Rate |
$1,801.41 |
| Rate for Payer: Aetna Commercial |
$393.30
|
| 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 |
$423.89
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$338.81
|
| Rate for Payer: BCN Commercial |
$338.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cofinity Commercial |
$410.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$437.00
|
| Rate for Payer: Healthscope Whirlpool |
$423.89
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$393.30
|
| 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 |
$371.45
|
| 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 |
$305.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$397.67
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$310.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$384.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL
|
Facility
|
IP
|
$437.00
|
|
|
Service Code
|
CPT 27613
|
| Hospital Charge Code |
27613
|
| Min. Negotiated Rate |
$305.90 |
| Max. Negotiated Rate |
$437.00 |
| Rate for Payer: Aetna Commercial |
$393.30
|
| Rate for Payer: ASR ASR |
$423.89
|
| Rate for Payer: BCBS Trust/PPO |
$338.81
|
| Rate for Payer: BCN Commercial |
$338.81
|
| Rate for Payer: Cash Price |
$349.60
|
| Rate for Payer: Cofinity Commercial |
$410.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.60
|
| Rate for Payer: Healthscope Commercial |
$437.00
|
| Rate for Payer: Healthscope Whirlpool |
$423.89
|
| Rate for Payer: Mclaren Commercial |
$393.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$371.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$384.56
|
|
|
PR BIOPSY SOFT TISSUE NECK/THORAX
|
Professional
|
Both
|
$448.00
|
|
|
Service Code
|
HCPCS 21550
|
| Min. Negotiated Rate |
$62.73 |
| Max. Negotiated Rate |
$392.89 |
| Rate for Payer: Aetna Commercial |
$203.96
|
| Rate for Payer: Aetna Medicare |
$152.21
|
| Rate for Payer: BCBS Complete |
$105.12
|
| Rate for Payer: BCBS MAPPO |
$152.21
|
| Rate for Payer: BCBS Trust/PPO |
$62.73
|
| Rate for Payer: BCN Commercial |
$392.89
|
| Rate for Payer: BCN Medicare Advantage |
$152.21
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cofinity Commercial |
$203.96
|
| Rate for Payer: Cofinity Commercial |
$219.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.21
|
| Rate for Payer: Healthscope Commercial |
$182.65
|
| Rate for Payer: Healthscope Whirlpool |
$182.65
|
| Rate for Payer: Meridian Medicaid |
$105.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$159.82
|
| Rate for Payer: PACE SWMI |
$152.21
|
| Rate for Payer: PHP Medicare Advantage |
$152.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.47
|
| Rate for Payer: Priority Health Medicare |
$152.21
|
| Rate for Payer: Priority Health Narrow Network |
$238.47
|
| Rate for Payer: UHC Medicare Advantage |
$156.78
|
|
|
PR BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL
|
Professional
|
Both
|
$585.00
|
|
|
Service Code
|
HCPCS 27040
|
| Min. Negotiated Rate |
$127.59 |
| Max. Negotiated Rate |
$498.94 |
| Rate for Payer: Aetna Commercial |
$260.75
|
| Rate for Payer: Aetna Medicare |
$194.59
|
| Rate for Payer: BCBS Complete |
$133.97
|
| Rate for Payer: BCBS MAPPO |
$194.59
|
| Rate for Payer: BCBS Trust/PPO |
$289.10
|
| Rate for Payer: BCN Commercial |
$498.94
|
| Rate for Payer: BCN Medicare Advantage |
$194.59
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Cash Price |
$468.00
|
| Rate for Payer: Cofinity Commercial |
$260.75
|
| Rate for Payer: Cofinity Commercial |
$280.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.59
|
| Rate for Payer: Healthscope Commercial |
$233.51
|
| Rate for Payer: Healthscope Whirlpool |
$233.51
|
| Rate for Payer: Meridian Medicaid |
$133.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$204.32
|
| Rate for Payer: PACE SWMI |
$194.59
|
| Rate for Payer: PHP Medicare Advantage |
$194.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$409.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$303.33
|
| Rate for Payer: Priority Health Medicare |
$194.59
|
| Rate for Payer: Priority Health Narrow Network |
$303.33
|
| Rate for Payer: UHC Medicare Advantage |
$200.43
|
|
|
PR BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM
|
Professional
|
Both
|
$1,396.00
|
|
|
Service Code
|
HCPCS 27041
|
| Min. Negotiated Rate |
$316.44 |
| Max. Negotiated Rate |
$1,090.75 |
| Rate for Payer: Aetna Commercial |
$939.51
|
| Rate for Payer: Aetna Medicare |
$701.13
|
| Rate for Payer: BCBS Complete |
$479.96
|
| Rate for Payer: BCBS MAPPO |
$701.13
|
| Rate for Payer: BCBS Trust/PPO |
$316.44
|
| Rate for Payer: BCN Commercial |
$1,043.82
|
| Rate for Payer: BCN Medicare Advantage |
$701.13
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Cash Price |
$1,116.80
|
| Rate for Payer: Cofinity Commercial |
$939.51
|
| Rate for Payer: Cofinity Commercial |
$1,009.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$701.13
|
| Rate for Payer: Healthscope Commercial |
$841.36
|
| Rate for Payer: Healthscope Whirlpool |
$841.36
|
| Rate for Payer: Meridian Medicaid |
$479.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$736.19
|
| Rate for Payer: PACE SWMI |
$701.13
|
| Rate for Payer: PHP Medicare Advantage |
$701.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$457.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$977.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,090.75
|
| Rate for Payer: Priority Health Medicare |
$701.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,090.75
|
| Rate for Payer: UHC Medicare Advantage |
$722.16
|
|
|
PR BIOPSY SOFT TISSUE SHOULDER DEEP
|
Professional
|
Both
|
$831.00
|
|
|
Service Code
|
HCPCS 23066
|
| Min. Negotiated Rate |
$240.26 |
| Max. Negotiated Rate |
$833.19 |
| Rate for Payer: Aetna Commercial |
$480.52
|
| Rate for Payer: Aetna Medicare |
$358.60
|
| Rate for Payer: BCBS Complete |
$252.27
|
| Rate for Payer: BCBS MAPPO |
$358.60
|
| Rate for Payer: BCBS Trust/PPO |
$426.87
|
| Rate for Payer: BCN Commercial |
$833.19
|
| Rate for Payer: BCN Medicare Advantage |
$358.60
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cash Price |
$664.80
|
| Rate for Payer: Cofinity Commercial |
$480.52
|
| Rate for Payer: Cofinity Commercial |
$516.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$358.60
|
| Rate for Payer: Healthscope Commercial |
$430.32
|
| Rate for Payer: Healthscope Whirlpool |
$430.32
|
| Rate for Payer: Meridian Medicaid |
$252.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$376.53
|
| Rate for Payer: PACE SWMI |
$358.60
|
| Rate for Payer: PHP Medicare Advantage |
$358.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$581.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$563.75
|
| Rate for Payer: Priority Health Medicare |
$358.60
|
| Rate for Payer: Priority Health Narrow Network |
$563.75
|
| Rate for Payer: UHC Medicare Advantage |
$369.36
|
|
|
PR BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP
|
Professional
|
Both
|
$682.00
|
|
|
Service Code
|
HCPCS 27324
|
| Min. Negotiated Rate |
$267.32 |
| Max. Negotiated Rate |
$1,614.48 |
| Rate for Payer: Aetna Commercial |
$542.20
|
| Rate for Payer: Aetna Medicare |
$404.63
|
| Rate for Payer: BCBS Complete |
$280.69
|
| Rate for Payer: BCBS MAPPO |
$404.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,614.48
|
| Rate for Payer: BCN Commercial |
$606.45
|
| Rate for Payer: BCN Medicare Advantage |
$404.63
|
| Rate for Payer: Cash Price |
$545.60
|
| Rate for Payer: Cash Price |
$545.60
|
| Rate for Payer: Cofinity Commercial |
$582.67
|
| Rate for Payer: Cofinity Commercial |
$542.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.63
|
| Rate for Payer: Healthscope Commercial |
$485.56
|
| Rate for Payer: Healthscope Whirlpool |
$485.56
|
| Rate for Payer: Meridian Medicaid |
$280.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$424.86
|
| Rate for Payer: PACE SWMI |
$404.63
|
| Rate for Payer: PHP Medicare Advantage |
$404.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$633.72
|
| Rate for Payer: Priority Health Medicare |
$404.63
|
| Rate for Payer: Priority Health Narrow Network |
$633.72
|
| Rate for Payer: UHC Medicare Advantage |
$416.77
|
|
|
PR BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL
|
Professional
|
Both
|
$472.00
|
|
|
Service Code
|
HCPCS 27323
|
| Min. Negotiated Rate |
$112.68 |
| Max. Negotiated Rate |
$2,259.54 |
| Rate for Payer: Aetna Commercial |
$228.72
|
| Rate for Payer: Aetna Medicare |
$170.69
|
| Rate for Payer: BCBS Complete |
$118.31
|
| Rate for Payer: BCBS MAPPO |
$170.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,259.54
|
| Rate for Payer: BCN Commercial |
$402.67
|
| Rate for Payer: BCN Medicare Advantage |
$170.69
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cofinity Commercial |
$245.79
|
| Rate for Payer: Cofinity Commercial |
$228.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.69
|
| Rate for Payer: Healthscope Commercial |
$204.83
|
| Rate for Payer: Healthscope Whirlpool |
$204.83
|
| Rate for Payer: Meridian Medicaid |
$118.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$179.22
|
| Rate for Payer: PACE SWMI |
$170.69
|
| Rate for Payer: PHP Medicare Advantage |
$170.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$267.58
|
| Rate for Payer: Priority Health Medicare |
$170.69
|
| Rate for Payer: Priority Health Narrow Network |
$267.58
|
| Rate for Payer: UHC Medicare Advantage |
$175.81
|
|
|
PR BIOPSY SOFT TISSUE UPPER ARM/ELBOW AREA DEEP
|
Professional
|
Both
|
$1,052.00
|
|
|
Service Code
|
HCPCS 24066
|
| Min. Negotiated Rate |
$75.99 |
| Max. Negotiated Rate |
$920.67 |
| Rate for Payer: Aetna Commercial |
$555.79
|
| Rate for Payer: Aetna Medicare |
$414.77
|
| Rate for Payer: BCBS Complete |
$288.73
|
| Rate for Payer: BCBS MAPPO |
$414.77
|
| Rate for Payer: BCBS Trust/PPO |
$75.99
|
| Rate for Payer: BCN Commercial |
$920.67
|
| Rate for Payer: BCN Medicare Advantage |
$414.77
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cash Price |
$841.60
|
| Rate for Payer: Cofinity Commercial |
$555.79
|
| Rate for Payer: Cofinity Commercial |
$597.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$414.77
|
| Rate for Payer: Healthscope Commercial |
$497.72
|
| Rate for Payer: Healthscope Whirlpool |
$497.72
|
| Rate for Payer: Meridian Medicaid |
$288.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$435.51
|
| Rate for Payer: PACE SWMI |
$414.77
|
| Rate for Payer: PHP Medicare Advantage |
$414.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$649.04
|
| Rate for Payer: Priority Health Medicare |
$414.77
|
| Rate for Payer: Priority Health Narrow Network |
$649.04
|
| Rate for Payer: UHC Medicare Advantage |
$427.21
|
|
|
PR BIOPSY SOFT TISSUE UPPER ARM/ELBOW SUPERFICIAL
|
Professional
|
Both
|
$458.00
|
|
|
Service Code
|
HCPCS 24065
|
| Min. Negotiated Rate |
$105.01 |
| Max. Negotiated Rate |
$380.19 |
| Rate for Payer: Aetna Commercial |
$211.91
|
| Rate for Payer: Aetna Medicare |
$158.14
|
| Rate for Payer: BCBS Complete |
$110.26
|
| Rate for Payer: BCBS MAPPO |
$158.14
|
| Rate for Payer: BCBS Trust/PPO |
$126.93
|
| Rate for Payer: BCN Commercial |
$380.19
|
| Rate for Payer: BCN Medicare Advantage |
$158.14
|
| Rate for Payer: Cash Price |
$366.40
|
| Rate for Payer: Cash Price |
$366.40
|
| Rate for Payer: Cofinity Commercial |
$227.72
|
| Rate for Payer: Cofinity Commercial |
$211.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.14
|
| Rate for Payer: Healthscope Commercial |
$189.77
|
| Rate for Payer: Healthscope Whirlpool |
$189.77
|
| Rate for Payer: Meridian Medicaid |
$110.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$166.05
|
| Rate for Payer: PACE SWMI |
$158.14
|
| Rate for Payer: PHP Medicare Advantage |
$158.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$320.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.17
|
| Rate for Payer: Priority Health Medicare |
$158.14
|
| Rate for Payer: Priority Health Narrow Network |
$248.17
|
| Rate for Payer: UHC Medicare Advantage |
$162.88
|
|
