|
PR CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA
|
Professional
|
Both
|
$354.00
|
|
|
Service Code
|
HCPCS 64616
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$3,744.06 |
| Rate for Payer: Aetna Commercial |
$144.45
|
| Rate for Payer: Aetna Medicare |
$107.80
|
| Rate for Payer: BCBS Complete |
$74.02
|
| Rate for Payer: BCBS MAPPO |
$107.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,744.06
|
| Rate for Payer: BCN Commercial |
$200.85
|
| Rate for Payer: BCN Medicare Advantage |
$107.80
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cofinity Commercial |
$155.23
|
| Rate for Payer: Cofinity Commercial |
$144.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.80
|
| Rate for Payer: Healthscope Commercial |
$129.36
|
| Rate for Payer: Healthscope Whirlpool |
$129.36
|
| Rate for Payer: Meridian Medicaid |
$74.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$113.19
|
| Rate for Payer: PACE SWMI |
$107.80
|
| Rate for Payer: PHP Medicare Advantage |
$107.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.02
|
| Rate for Payer: Priority Health Medicare |
$107.80
|
| Rate for Payer: Priority Health Narrow Network |
$184.02
|
| Rate for Payer: UHC Medicare Advantage |
$111.03
|
|
|
PR CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES
|
Professional
|
Both
|
$303.00
|
|
|
Service Code
|
HCPCS 64646
|
| Min. Negotiated Rate |
$74.34 |
| Max. Negotiated Rate |
$2,036.60 |
| Rate for Payer: Aetna Commercial |
$153.66
|
| Rate for Payer: Aetna Medicare |
$114.67
|
| Rate for Payer: BCBS Complete |
$78.06
|
| Rate for Payer: BCBS MAPPO |
$114.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,036.60
|
| Rate for Payer: BCN Commercial |
$233.59
|
| Rate for Payer: BCN Medicare Advantage |
$114.67
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cash Price |
$242.40
|
| Rate for Payer: Cofinity Commercial |
$153.66
|
| Rate for Payer: Cofinity Commercial |
$165.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.67
|
| Rate for Payer: Healthscope Commercial |
$137.60
|
| Rate for Payer: Healthscope Whirlpool |
$137.60
|
| Rate for Payer: Meridian Medicaid |
$78.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$120.40
|
| Rate for Payer: PACE SWMI |
$114.67
|
| Rate for Payer: PHP Medicare Advantage |
$114.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$195.35
|
| Rate for Payer: Priority Health Medicare |
$114.67
|
| Rate for Payer: Priority Health Narrow Network |
$195.35
|
| Rate for Payer: UHC Medicare Advantage |
$118.11
|
|
|
PR CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE
|
Professional
|
Both
|
$390.00
|
|
|
Service Code
|
HCPCS 64642
|
| Min. Negotiated Rate |
$68.59 |
| Max. Negotiated Rate |
$805.66 |
| Rate for Payer: Aetna Commercial |
$140.23
|
| Rate for Payer: Aetna Medicare |
$104.65
|
| Rate for Payer: BCBS Complete |
$72.02
|
| Rate for Payer: BCBS MAPPO |
$104.65
|
| Rate for Payer: BCBS Trust/PPO |
$805.66
|
| Rate for Payer: BCN Commercial |
$220.39
|
| Rate for Payer: BCN Medicare Advantage |
$104.65
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cofinity Commercial |
$150.70
|
| Rate for Payer: Cofinity Commercial |
$140.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.65
|
| Rate for Payer: Healthscope Commercial |
$125.58
|
| Rate for Payer: Healthscope Whirlpool |
$125.58
|
| Rate for Payer: Meridian Medicaid |
$72.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$109.88
|
| Rate for Payer: PACE SWMI |
$104.65
|
| Rate for Payer: PHP Medicare Advantage |
$104.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.92
|
| Rate for Payer: Priority Health Medicare |
$104.65
|
| Rate for Payer: Priority Health Narrow Network |
$178.92
|
| Rate for Payer: UHC Medicare Advantage |
$107.79
|
|
|
PR CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 64611
|
| Min. Negotiated Rate |
$73.06 |
| Max. Negotiated Rate |
$939.85 |
| Rate for Payer: Aetna Commercial |
$144.76
|
| Rate for Payer: Aetna Medicare |
$108.03
|
| Rate for Payer: BCBS Complete |
$76.71
|
| Rate for Payer: BCBS MAPPO |
$108.03
|
| Rate for Payer: BCBS Trust/PPO |
$939.85
|
| Rate for Payer: BCN Commercial |
$190.10
|
| Rate for Payer: BCN Medicare Advantage |
$108.03
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$155.56
|
| Rate for Payer: Cofinity Commercial |
$144.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.03
|
| Rate for Payer: Healthscope Commercial |
$129.64
|
| Rate for Payer: Healthscope Whirlpool |
$129.64
|
| Rate for Payer: Meridian Medicaid |
$76.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$113.43
|
| Rate for Payer: PACE SWMI |
$108.03
|
| Rate for Payer: PHP Medicare Advantage |
$108.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$188.55
|
| Rate for Payer: Priority Health Medicare |
$108.03
|
| Rate for Payer: Priority Health Narrow Network |
$188.55
|
| Rate for Payer: UHC Medicare Advantage |
$111.27
|
|
|
PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 64615
|
| Min. Negotiated Rate |
$78.81 |
| Max. Negotiated Rate |
$2,950.03 |
| Rate for Payer: Aetna Commercial |
$164.58
|
| Rate for Payer: Aetna Medicare |
$122.82
|
| Rate for Payer: BCBS Complete |
$82.75
|
| Rate for Payer: BCBS MAPPO |
$122.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,950.03
|
| Rate for Payer: BCN Commercial |
$226.26
|
| Rate for Payer: BCN Medicare Advantage |
$122.82
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$176.86
|
| Rate for Payer: Cofinity Commercial |
$164.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.82
|
| Rate for Payer: Healthscope Commercial |
$147.38
|
| Rate for Payer: Healthscope Whirlpool |
$147.38
|
| Rate for Payer: Meridian Medicaid |
$82.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$128.96
|
| Rate for Payer: PACE SWMI |
$122.82
|
| Rate for Payer: PHP Medicare Advantage |
$122.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.36
|
| Rate for Payer: Priority Health Medicare |
$122.82
|
| Rate for Payer: Priority Health Narrow Network |
$208.36
|
| Rate for Payer: UHC Medicare Advantage |
$126.50
|
|
|
PR CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL
|
Professional
|
Both
|
$319.00
|
|
|
Service Code
|
HCPCS 64612
|
| Min. Negotiated Rate |
$76.68 |
| Max. Negotiated Rate |
$2,247.92 |
| Rate for Payer: Aetna Commercial |
$154.31
|
| Rate for Payer: Aetna Medicare |
$115.16
|
| Rate for Payer: BCBS Complete |
$80.51
|
| Rate for Payer: BCBS MAPPO |
$115.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,247.92
|
| Rate for Payer: BCN Commercial |
$160.60
|
| Rate for Payer: BCN Medicare Advantage |
$115.16
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cofinity Commercial |
$165.83
|
| Rate for Payer: Cofinity Commercial |
$154.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.16
|
| Rate for Payer: Healthscope Commercial |
$138.19
|
| Rate for Payer: Healthscope Whirlpool |
$138.19
|
| Rate for Payer: Meridian Medicaid |
$80.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$120.92
|
| Rate for Payer: PACE SWMI |
$115.16
|
| Rate for Payer: PHP Medicare Advantage |
$115.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.44
|
| Rate for Payer: Priority Health Medicare |
$115.16
|
| Rate for Payer: Priority Health Narrow Network |
$200.44
|
| Rate for Payer: UHC Medicare Advantage |
$118.61
|
|
|
PR CHEMOTHERAPY ADMN IV INFUSION TQ EA HR
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 96415
|
| Min. Negotiated Rate |
$26.62 |
| Max. Negotiated Rate |
$1,570.64 |
| Rate for Payer: Aetna Commercial |
$35.67
|
| Rate for Payer: Aetna Medicare |
$26.62
|
| Rate for Payer: BCBS Complete |
$52.00
|
| Rate for Payer: BCBS MAPPO |
$26.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,570.64
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: BCN Medicare Advantage |
$26.62
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$38.33
|
| Rate for Payer: Cofinity Commercial |
$35.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.62
|
| Rate for Payer: Healthscope Commercial |
$31.94
|
| Rate for Payer: Healthscope Whirlpool |
$31.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.95
|
| Rate for Payer: PACE SWMI |
$26.62
|
| Rate for Payer: PHP Medicare Advantage |
$26.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.73
|
| Rate for Payer: Priority Health Medicare |
$26.62
|
| Rate for Payer: Priority Health Narrow Network |
$37.73
|
| Rate for Payer: UHC Medicare Advantage |
$27.42
|
|
|
PR CHEMOTX ADMN CNS REQ SPINAL PUNCTURE
|
Professional
|
Both
|
$719.00
|
|
|
Service Code
|
HCPCS 96450
|
| Min. Negotiated Rate |
$48.14 |
| Max. Negotiated Rate |
$889.66 |
| Rate for Payer: Aetna Commercial |
$101.13
|
| Rate for Payer: Aetna Medicare |
$75.47
|
| Rate for Payer: BCBS Complete |
$50.55
|
| Rate for Payer: BCBS MAPPO |
$75.47
|
| Rate for Payer: BCBS Trust/PPO |
$889.66
|
| Rate for Payer: BCN Commercial |
$240.92
|
| Rate for Payer: BCN Medicare Advantage |
$75.47
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cash Price |
$575.20
|
| Rate for Payer: Cofinity Commercial |
$108.68
|
| Rate for Payer: Cofinity Commercial |
$101.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.47
|
| Rate for Payer: Healthscope Commercial |
$90.56
|
| Rate for Payer: Healthscope Whirlpool |
$90.56
|
| Rate for Payer: Meridian Medicaid |
$50.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$79.24
|
| Rate for Payer: PACE SWMI |
$75.47
|
| Rate for Payer: PHP Medicare Advantage |
$75.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$503.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.95
|
| Rate for Payer: Priority Health Medicare |
$75.47
|
| Rate for Payer: Priority Health Narrow Network |
$101.95
|
| Rate for Payer: UHC Medicare Advantage |
$77.73
|
|
|
PR CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 96417
|
| Min. Negotiated Rate |
$51.60 |
| Max. Negotiated Rate |
$1,846.41 |
| Rate for Payer: Aetna Commercial |
$80.57
|
| Rate for Payer: Aetna Medicare |
$60.13
|
| Rate for Payer: BCBS Complete |
$51.60
|
| Rate for Payer: BCBS MAPPO |
$60.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,846.41
|
| Rate for Payer: BCN Commercial |
$93.82
|
| Rate for Payer: BCN Medicare Advantage |
$60.13
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$86.59
|
| Rate for Payer: Cofinity Commercial |
$80.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.13
|
| Rate for Payer: Healthscope Commercial |
$72.16
|
| Rate for Payer: Healthscope Whirlpool |
$72.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$63.14
|
| Rate for Payer: PACE SWMI |
$60.13
|
| Rate for Payer: PHP Medicare Advantage |
$60.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.23
|
| Rate for Payer: Priority Health Medicare |
$60.13
|
| Rate for Payer: Priority Health Narrow Network |
$86.23
|
| Rate for Payer: UHC Medicare Advantage |
$61.93
|
|
|
PR CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG
|
Professional
|
Both
|
$243.00
|
|
|
Service Code
|
HCPCS 96413
|
| Min. Negotiated Rate |
$97.20 |
| Max. Negotiated Rate |
$1,457.05 |
| Rate for Payer: Aetna Commercial |
$162.98
|
| Rate for Payer: Aetna Medicare |
$121.63
|
| Rate for Payer: BCBS Complete |
$97.20
|
| Rate for Payer: BCBS MAPPO |
$121.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,457.05
|
| Rate for Payer: BCN Commercial |
$190.59
|
| Rate for Payer: BCN Medicare Advantage |
$121.63
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cofinity Commercial |
$175.15
|
| Rate for Payer: Cofinity Commercial |
$162.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.63
|
| Rate for Payer: Healthscope Commercial |
$145.96
|
| Rate for Payer: Healthscope Whirlpool |
$145.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$127.71
|
| Rate for Payer: PACE SWMI |
$121.63
|
| Rate for Payer: PHP Medicare Advantage |
$121.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.17
|
| Rate for Payer: Priority Health Medicare |
$121.63
|
| Rate for Payer: Priority Health Narrow Network |
$175.17
|
| Rate for Payer: UHC Medicare Advantage |
$125.28
|
|
|
PR CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG
|
Professional
|
Both
|
$203.00
|
|
|
Service Code
|
HCPCS 96409
|
| Min. Negotiated Rate |
$81.20 |
| Max. Negotiated Rate |
$1,506.18 |
| Rate for Payer: Aetna Commercial |
$125.93
|
| Rate for Payer: Aetna Medicare |
$93.98
|
| Rate for Payer: BCBS Complete |
$81.20
|
| Rate for Payer: BCBS MAPPO |
$93.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,506.18
|
| Rate for Payer: BCN Commercial |
$147.09
|
| Rate for Payer: BCN Medicare Advantage |
$93.98
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cofinity Commercial |
$135.33
|
| Rate for Payer: Cofinity Commercial |
$125.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.98
|
| Rate for Payer: Healthscope Commercial |
$112.78
|
| Rate for Payer: Healthscope Whirlpool |
$112.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.68
|
| Rate for Payer: PACE SWMI |
$93.98
|
| Rate for Payer: PHP Medicare Advantage |
$93.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.19
|
| Rate for Payer: Priority Health Medicare |
$93.98
|
| Rate for Payer: Priority Health Narrow Network |
$135.19
|
| Rate for Payer: UHC Medicare Advantage |
$96.80
|
|
|
PR CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 96411
|
| Min. Negotiated Rate |
$46.00 |
| Max. Negotiated Rate |
$1,466.56 |
| Rate for Payer: Aetna Commercial |
$69.36
|
| Rate for Payer: Aetna Medicare |
$51.76
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: BCBS MAPPO |
$51.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,466.56
|
| Rate for Payer: BCN Commercial |
$80.63
|
| Rate for Payer: BCN Medicare Advantage |
$51.76
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$74.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.76
|
| Rate for Payer: Healthscope Commercial |
$62.11
|
| Rate for Payer: Healthscope Whirlpool |
$62.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$54.35
|
| Rate for Payer: PACE SWMI |
$51.76
|
| Rate for Payer: PHP Medicare Advantage |
$51.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.10
|
| Rate for Payer: Priority Health Medicare |
$51.76
|
| Rate for Payer: Priority Health Narrow Network |
$74.10
|
| Rate for Payer: UHC Medicare Advantage |
$53.31
|
|
|
PR CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 96402
|
| Min. Negotiated Rate |
$31.86 |
| Max. Negotiated Rate |
$1,217.73 |
| Rate for Payer: Aetna Commercial |
$42.69
|
| Rate for Payer: Aetna Medicare |
$31.86
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: BCBS MAPPO |
$31.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,217.73
|
| Rate for Payer: BCN Commercial |
$49.36
|
| Rate for Payer: BCN Medicare Advantage |
$31.86
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$45.88
|
| Rate for Payer: Cofinity Commercial |
$42.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.86
|
| Rate for Payer: Healthscope Commercial |
$38.23
|
| Rate for Payer: Healthscope Whirlpool |
$38.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.45
|
| Rate for Payer: PACE SWMI |
$31.86
|
| Rate for Payer: PHP Medicare Advantage |
$31.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.37
|
| Rate for Payer: Priority Health Medicare |
$31.86
|
| Rate for Payer: Priority Health Narrow Network |
$45.37
|
| Rate for Payer: UHC Medicare Advantage |
$32.82
|
|
|
PR CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 96401
|
| Min. Negotiated Rate |
$45.60 |
| Max. Negotiated Rate |
$1,111.54 |
| Rate for Payer: Aetna Commercial |
$90.92
|
| Rate for Payer: Aetna Medicare |
$67.85
|
| Rate for Payer: BCBS Complete |
$45.60
|
| Rate for Payer: BCBS MAPPO |
$67.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,111.54
|
| Rate for Payer: BCN Commercial |
$106.04
|
| Rate for Payer: BCN Medicare Advantage |
$67.85
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$97.70
|
| Rate for Payer: Cofinity Commercial |
$90.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.85
|
| Rate for Payer: Healthscope Commercial |
$81.42
|
| Rate for Payer: Healthscope Whirlpool |
$81.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$71.24
|
| Rate for Payer: PACE SWMI |
$67.85
|
| Rate for Payer: PHP Medicare Advantage |
$67.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.47
|
| Rate for Payer: Priority Health Medicare |
$67.85
|
| Rate for Payer: Priority Health Narrow Network |
$97.47
|
| Rate for Payer: UHC Medicare Advantage |
$69.89
|
|
|
PR CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS 96542
|
| Min. Negotiated Rate |
$26.63 |
| Max. Negotiated Rate |
$1,570.64 |
| Rate for Payer: Aetna Commercial |
$54.78
|
| Rate for Payer: Aetna Medicare |
$40.88
|
| Rate for Payer: BCBS Complete |
$27.96
|
| Rate for Payer: BCBS MAPPO |
$40.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,570.64
|
| Rate for Payer: BCN Commercial |
$189.12
|
| Rate for Payer: BCN Medicare Advantage |
$40.88
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$54.78
|
| Rate for Payer: Cofinity Commercial |
$58.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.88
|
| Rate for Payer: Healthscope Commercial |
$49.06
|
| Rate for Payer: Healthscope Whirlpool |
$49.06
|
| Rate for Payer: Meridian Medicaid |
$27.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$42.92
|
| Rate for Payer: PACE SWMI |
$40.88
|
| Rate for Payer: PHP Medicare Advantage |
$40.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.69
|
| Rate for Payer: Priority Health Medicare |
$40.88
|
| Rate for Payer: Priority Health Narrow Network |
$55.69
|
| Rate for Payer: UHC Medicare Advantage |
$42.11
|
|
|
PR CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 98941
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$583.77 |
| Rate for Payer: Aetna Commercial |
$44.31
|
| Rate for Payer: Aetna Medicare |
$33.07
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: BCBS MAPPO |
$33.07
|
| Rate for Payer: BCBS Trust/PPO |
$583.77
|
| Rate for Payer: BCN Commercial |
$38.50
|
| Rate for Payer: BCN Medicare Advantage |
$33.07
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$47.62
|
| Rate for Payer: Cofinity Commercial |
$44.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.07
|
| Rate for Payer: Healthscope Commercial |
$39.68
|
| Rate for Payer: Healthscope Whirlpool |
$39.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34.72
|
| Rate for Payer: PACE SWMI |
$33.07
|
| Rate for Payer: PHP Medicare Advantage |
$33.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.92
|
| Rate for Payer: Priority Health Medicare |
$33.07
|
| Rate for Payer: Priority Health Narrow Network |
$44.92
|
| Rate for Payer: UHC Medicare Advantage |
$34.06
|
|
|
PR CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 50688
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$2,900.37 |
| Rate for Payer: Aetna Commercial |
$97.34
|
| Rate for Payer: BCBS Complete |
$51.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,900.37
|
| Rate for Payer: BCN Commercial |
$111.42
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Meridian Medicaid |
$51.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$123.20
|
| Rate for Payer: Priority Health Narrow Network |
$123.20
|
|
|
PR CHOLECSTC EXPL DUX SPHNCTROTOMY/SPHNCTROP
|
Professional
|
Both
|
$2,078.00
|
|
|
Service Code
|
HCPCS 47620
|
| Min. Negotiated Rate |
$521.43 |
| Max. Negotiated Rate |
$2,414.81 |
| Rate for Payer: Aetna Commercial |
$1,835.51
|
| Rate for Payer: Aetna Medicare |
$1,369.78
|
| Rate for Payer: BCBS Complete |
$922.11
|
| Rate for Payer: BCBS MAPPO |
$1,369.78
|
| Rate for Payer: BCBS Trust/PPO |
$521.43
|
| Rate for Payer: BCN Commercial |
$2,007.00
|
| Rate for Payer: BCN Medicare Advantage |
$1,369.78
|
| Rate for Payer: Cash Price |
$1,662.40
|
| Rate for Payer: Cash Price |
$1,662.40
|
| Rate for Payer: Cofinity Commercial |
$1,972.48
|
| Rate for Payer: Cofinity Commercial |
$1,835.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,369.78
|
| Rate for Payer: Healthscope Commercial |
$1,643.74
|
| Rate for Payer: Healthscope Whirlpool |
$1,643.74
|
| Rate for Payer: Meridian Medicaid |
$922.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,438.27
|
| Rate for Payer: PACE SWMI |
$1,369.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,369.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$878.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,454.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,414.81
|
| Rate for Payer: Priority Health Medicare |
$1,369.78
|
| Rate for Payer: Priority Health Narrow Network |
$2,414.81
|
| Rate for Payer: UHC Medicare Advantage |
$1,410.87
|
|
|
PR CHOLECSTONTRSTM ROUX-EN-Y W/GASTRONTRSTM
|
Professional
|
Both
|
$2,592.00
|
|
|
Service Code
|
HCPCS 47741
|
| Min. Negotiated Rate |
$446.41 |
| Max. Negotiated Rate |
$2,592.97 |
| Rate for Payer: Aetna Commercial |
$1,967.55
|
| Rate for Payer: Aetna Medicare |
$1,468.32
|
| Rate for Payer: BCBS Complete |
$990.32
|
| Rate for Payer: BCBS MAPPO |
$1,468.32
|
| Rate for Payer: BCBS Trust/PPO |
$446.41
|
| Rate for Payer: BCN Commercial |
$2,155.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,468.32
|
| Rate for Payer: Cash Price |
$2,073.60
|
| Rate for Payer: Cash Price |
$2,073.60
|
| Rate for Payer: Cofinity Commercial |
$2,114.38
|
| Rate for Payer: Cofinity Commercial |
$1,967.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,468.32
|
| Rate for Payer: Healthscope Commercial |
$1,761.98
|
| Rate for Payer: Healthscope Whirlpool |
$1,761.98
|
| Rate for Payer: Meridian Medicaid |
$990.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,541.74
|
| Rate for Payer: PACE SWMI |
$1,468.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,468.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$943.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,814.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,592.97
|
| Rate for Payer: Priority Health Medicare |
$1,468.32
|
| Rate for Payer: Priority Health Narrow Network |
$2,592.97
|
| Rate for Payer: UHC Medicare Advantage |
$1,512.37
|
|
|
PR CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX
|
Professional
|
Both
|
$2,572.00
|
|
|
Service Code
|
HCPCS 47480
|
| Min. Negotiated Rate |
$561.47 |
| Max. Negotiated Rate |
$1,800.40 |
| Rate for Payer: Aetna Commercial |
$1,163.87
|
| Rate for Payer: Aetna Medicare |
$868.56
|
| Rate for Payer: BCBS Complete |
$589.54
|
| Rate for Payer: BCBS MAPPO |
$868.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,405.28
|
| Rate for Payer: BCN Commercial |
$1,283.75
|
| Rate for Payer: BCN Medicare Advantage |
$868.56
|
| Rate for Payer: Cash Price |
$2,057.60
|
| Rate for Payer: Cash Price |
$2,057.60
|
| Rate for Payer: Cofinity Commercial |
$1,163.87
|
| Rate for Payer: Cofinity Commercial |
$1,250.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.56
|
| Rate for Payer: Healthscope Commercial |
$1,042.27
|
| Rate for Payer: Healthscope Whirlpool |
$1,042.27
|
| Rate for Payer: Meridian Medicaid |
$589.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$911.99
|
| Rate for Payer: PACE SWMI |
$868.56
|
| Rate for Payer: PHP Medicare Advantage |
$868.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$561.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,800.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,544.61
|
| Rate for Payer: Priority Health Medicare |
$868.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,544.61
|
| Rate for Payer: UHC Medicare Advantage |
$894.62
|
|
|
PR CHOLECYSTECTOMY
|
Facility
|
OP
|
$2,566.00
|
|
|
Service Code
|
CPT 47600
|
| Hospital Charge Code |
47600
|
| Min. Negotiated Rate |
$1,026.40 |
| Max. Negotiated Rate |
$2,566.00 |
| Rate for Payer: Aetna Commercial |
$2,309.40
|
| Rate for Payer: ASR ASR |
$2,489.02
|
| Rate for Payer: BCBS Complete |
$1,026.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,989.42
|
| Rate for Payer: BCN Commercial |
$1,989.42
|
| Rate for Payer: Cash Price |
$2,052.80
|
| Rate for Payer: Cofinity Commercial |
$2,412.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,052.80
|
| Rate for Payer: Healthscope Commercial |
$2,566.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,489.02
|
| Rate for Payer: Mclaren Commercial |
$2,309.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,181.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,796.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,335.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,821.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,258.08
|
|
|
PR CHOLECYSTECTOMY
|
Facility
|
IP
|
$2,566.00
|
|
|
Service Code
|
CPT 47600
|
| Hospital Charge Code |
47600
|
| Min. Negotiated Rate |
$1,796.20 |
| Max. Negotiated Rate |
$2,566.00 |
| Rate for Payer: Aetna Commercial |
$2,309.40
|
| Rate for Payer: ASR ASR |
$2,489.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,989.42
|
| Rate for Payer: BCN Commercial |
$1,989.42
|
| Rate for Payer: Cash Price |
$2,052.80
|
| Rate for Payer: Cofinity Commercial |
$2,412.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,052.80
|
| Rate for Payer: Healthscope Commercial |
$2,566.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,489.02
|
| Rate for Payer: Mclaren Commercial |
$2,309.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,181.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,796.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,258.08
|
|
|
PR CHOLECYSTECTOMY
|
Professional
|
Both
|
$2,566.00
|
|
|
Service Code
|
HCPCS 47600
|
| Min. Negotiated Rate |
$685.22 |
| Max. Negotiated Rate |
$2,558.03 |
| Rate for Payer: Aetna Commercial |
$1,425.20
|
| Rate for Payer: Aetna Medicare |
$1,063.58
|
| Rate for Payer: BCBS Complete |
$719.48
|
| Rate for Payer: BCBS MAPPO |
$1,063.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,558.03
|
| Rate for Payer: BCN Commercial |
$1,562.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,063.58
|
| Rate for Payer: Cash Price |
$2,052.80
|
| Rate for Payer: Cash Price |
$2,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,425.20
|
| Rate for Payer: Cofinity Commercial |
$1,531.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,063.58
|
| Rate for Payer: Healthscope Commercial |
$1,276.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,276.30
|
| Rate for Payer: Meridian Medicaid |
$719.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,116.76
|
| Rate for Payer: PACE SWMI |
$1,063.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,063.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$685.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,796.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,880.33
|
| Rate for Payer: Priority Health Medicare |
$1,063.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,880.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,095.49
|
|
|
PR CHOLECYSTECTOMY
|
Professional
|
Both
|
$2,566.00
|
|
|
Service Code
|
HCPCS 47600
|
| Hospital Charge Code |
47600
|
| Min. Negotiated Rate |
$685.22 |
| Max. Negotiated Rate |
$2,558.03 |
| Rate for Payer: Aetna Commercial |
$1,425.20
|
| Rate for Payer: Aetna Medicare |
$1,063.58
|
| Rate for Payer: BCBS Complete |
$719.48
|
| Rate for Payer: BCBS MAPPO |
$1,063.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,558.03
|
| Rate for Payer: BCN Commercial |
$1,562.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,063.58
|
| Rate for Payer: Cash Price |
$2,052.80
|
| Rate for Payer: Cash Price |
$2,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,531.56
|
| Rate for Payer: Cofinity Commercial |
$1,425.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,063.58
|
| Rate for Payer: Healthscope Commercial |
$1,276.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,276.30
|
| Rate for Payer: Meridian Medicaid |
$719.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,116.76
|
| Rate for Payer: PACE SWMI |
$1,063.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,063.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$685.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,796.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,880.33
|
| Rate for Payer: Priority Health Medicare |
$1,063.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,880.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,095.49
|
|
|
PR CHOLECYSTECTOMY EXPL DUCT CHOLEDOCHOENTEROSTOMY
|
Professional
|
Both
|
$4,618.00
|
|
|
Service Code
|
HCPCS 47612
|
| Min. Negotiated Rate |
$676.22 |
| Max. Negotiated Rate |
$3,232.60 |
| Rate for Payer: Aetna Commercial |
$1,699.12
|
| Rate for Payer: Aetna Medicare |
$1,268.00
|
| Rate for Payer: BCBS Complete |
$854.34
|
| Rate for Payer: BCBS MAPPO |
$1,268.00
|
| Rate for Payer: BCBS Trust/PPO |
$676.22
|
| Rate for Payer: BCN Commercial |
$1,858.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,268.00
|
| Rate for Payer: Cash Price |
$3,694.40
|
| Rate for Payer: Cash Price |
$3,694.40
|
| Rate for Payer: Cofinity Commercial |
$1,699.12
|
| Rate for Payer: Cofinity Commercial |
$1,825.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,268.00
|
| Rate for Payer: Healthscope Commercial |
$1,521.60
|
| Rate for Payer: Healthscope Whirlpool |
$1,521.60
|
| Rate for Payer: Meridian Medicaid |
$854.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,331.40
|
| Rate for Payer: PACE SWMI |
$1,268.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,268.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$813.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,232.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,236.65
|
| Rate for Payer: Priority Health Medicare |
$1,268.00
|
| Rate for Payer: Priority Health Narrow Network |
$2,236.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,306.04
|
|
