|
PR CRNEC TUM INFRATTL/POSTFOSSA CRBLOPNT ANGLE TUM
|
Professional
|
Both
|
$8,556.00
|
|
|
Service Code
|
HCPCS 61520
|
| Min. Negotiated Rate |
$1,140.60 |
| Max. Negotiated Rate |
$7,615.22 |
| Rate for Payer: Aetna Commercial |
$5,031.65
|
| Rate for Payer: Aetna Medicare |
$3,754.96
|
| Rate for Payer: BCBS Complete |
$2,516.06
|
| Rate for Payer: BCBS MAPPO |
$3,754.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,140.60
|
| Rate for Payer: BCN Commercial |
$7,615.22
|
| Rate for Payer: BCN Medicare Advantage |
$3,754.96
|
| Rate for Payer: Cash Price |
$6,844.80
|
| Rate for Payer: Cash Price |
$6,844.80
|
| Rate for Payer: Cofinity Commercial |
$5,407.14
|
| Rate for Payer: Cofinity Commercial |
$5,031.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,754.96
|
| Rate for Payer: Healthscope Commercial |
$4,505.95
|
| Rate for Payer: Healthscope Whirlpool |
$4,505.95
|
| Rate for Payer: Meridian Medicaid |
$2,516.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,942.71
|
| Rate for Payer: PACE SWMI |
$3,754.96
|
| Rate for Payer: PHP Medicare Advantage |
$3,754.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,396.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,989.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,360.39
|
| Rate for Payer: Priority Health Medicare |
$3,754.96
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.39
|
| Rate for Payer: UHC Medicare Advantage |
$3,867.61
|
|
|
PR CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF
|
Professional
|
Both
|
$2,713.00
|
|
|
Service Code
|
HCPCS 36825
|
| Min. Negotiated Rate |
$496.72 |
| Max. Negotiated Rate |
$1,899.10 |
| Rate for Payer: Aetna Commercial |
$1,044.42
|
| Rate for Payer: Aetna Medicare |
$779.42
|
| Rate for Payer: BCBS Complete |
$521.56
|
| Rate for Payer: BCBS MAPPO |
$779.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,014.86
|
| Rate for Payer: BCN Commercial |
$1,135.69
|
| Rate for Payer: BCN Medicare Advantage |
$779.42
|
| Rate for Payer: Cash Price |
$2,170.40
|
| Rate for Payer: Cash Price |
$2,170.40
|
| Rate for Payer: Cofinity Commercial |
$1,122.36
|
| Rate for Payer: Cofinity Commercial |
$1,044.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$779.42
|
| Rate for Payer: Healthscope Commercial |
$935.30
|
| Rate for Payer: Healthscope Whirlpool |
$935.30
|
| Rate for Payer: Meridian Medicaid |
$521.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$818.39
|
| Rate for Payer: PACE SWMI |
$779.42
|
| Rate for Payer: PHP Medicare Advantage |
$779.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$496.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,899.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,236.27
|
| Rate for Payer: Priority Health Medicare |
$779.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,236.27
|
| Rate for Payer: UHC Medicare Advantage |
$802.80
|
|
|
PR CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF
|
Professional
|
Both
|
$1,353.00
|
|
|
Service Code
|
HCPCS 36830
|
| Min. Negotiated Rate |
$417.05 |
| Max. Negotiated Rate |
$1,037.85 |
| Rate for Payer: Aetna Commercial |
$877.35
|
| Rate for Payer: Aetna Medicare |
$654.74
|
| Rate for Payer: BCBS Complete |
$437.90
|
| Rate for Payer: BCBS MAPPO |
$654.74
|
| Rate for Payer: BCBS Trust/PPO |
$967.85
|
| Rate for Payer: BCN Commercial |
$953.41
|
| Rate for Payer: BCN Medicare Advantage |
$654.74
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cofinity Commercial |
$877.35
|
| Rate for Payer: Cofinity Commercial |
$942.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$654.74
|
| Rate for Payer: Healthscope Commercial |
$785.69
|
| Rate for Payer: Healthscope Whirlpool |
$785.69
|
| Rate for Payer: Meridian Medicaid |
$437.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$687.48
|
| Rate for Payer: PACE SWMI |
$654.74
|
| Rate for Payer: PHP Medicare Advantage |
$654.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$417.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$947.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,037.85
|
| Rate for Payer: Priority Health Medicare |
$654.74
|
| Rate for Payer: Priority Health Narrow Network |
$1,037.85
|
| Rate for Payer: UHC Medicare Advantage |
$674.38
|
|
|
PR CRTJ DSTL ARVEN FSTL LXTR BYP SURG NON-HEMO
|
Professional
|
Both
|
$335.00
|
|
|
Service Code
|
HCPCS 35686
|
| Min. Negotiated Rate |
$99.68 |
| Max. Negotiated Rate |
$1,316.52 |
| Rate for Payer: Aetna Commercial |
$212.68
|
| Rate for Payer: Aetna Medicare |
$158.72
|
| Rate for Payer: BCBS Complete |
$104.66
|
| Rate for Payer: BCBS MAPPO |
$158.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,316.52
|
| Rate for Payer: BCN Commercial |
$228.22
|
| Rate for Payer: BCN Medicare Advantage |
$158.72
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cofinity Commercial |
$228.56
|
| Rate for Payer: Cofinity Commercial |
$212.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.72
|
| Rate for Payer: Healthscope Commercial |
$190.46
|
| Rate for Payer: Healthscope Whirlpool |
$190.46
|
| Rate for Payer: Meridian Medicaid |
$104.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$166.66
|
| Rate for Payer: PACE SWMI |
$158.72
|
| Rate for Payer: PHP Medicare Advantage |
$158.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$248.42
|
| Rate for Payer: Priority Health Medicare |
$158.72
|
| Rate for Payer: Priority Health Narrow Network |
$248.42
|
| Rate for Payer: UHC Medicare Advantage |
$163.48
|
|
|
PR CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX
|
Professional
|
Both
|
$2,500.00
|
|
|
Service Code
|
HCPCS 33025
|
| Min. Negotiated Rate |
$485.85 |
| Max. Negotiated Rate |
$1,750.00 |
| Rate for Payer: Aetna Commercial |
$1,014.72
|
| Rate for Payer: Aetna Medicare |
$757.25
|
| Rate for Payer: BCBS Complete |
$510.14
|
| Rate for Payer: BCBS MAPPO |
$757.25
|
| Rate for Payer: BCBS Trust/PPO |
$724.83
|
| Rate for Payer: BCN Commercial |
$1,108.32
|
| Rate for Payer: BCN Medicare Advantage |
$757.25
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cofinity Commercial |
$1,090.44
|
| Rate for Payer: Cofinity Commercial |
$1,014.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$757.25
|
| Rate for Payer: Healthscope Commercial |
$908.70
|
| Rate for Payer: Healthscope Whirlpool |
$908.70
|
| Rate for Payer: Meridian Medicaid |
$510.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$795.11
|
| Rate for Payer: PACE SWMI |
$757.25
|
| Rate for Payer: PHP Medicare Advantage |
$757.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$485.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,750.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,206.48
|
| Rate for Payer: Priority Health Medicare |
$757.25
|
| Rate for Payer: Priority Health Narrow Network |
$1,206.48
|
| Rate for Payer: UHC Medicare Advantage |
$779.97
|
|
|
PR CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL/OTH W/LAM
|
Professional
|
Both
|
$4,279.00
|
|
|
Service Code
|
HCPCS 63740
|
| Min. Negotiated Rate |
$254.64 |
| Max. Negotiated Rate |
$2,995.30 |
| Rate for Payer: Aetna Commercial |
$1,328.36
|
| Rate for Payer: Aetna Medicare |
$991.31
|
| Rate for Payer: BCBS Complete |
$676.77
|
| Rate for Payer: BCBS MAPPO |
$991.31
|
| Rate for Payer: BCBS Trust/PPO |
$254.64
|
| Rate for Payer: BCN Commercial |
$1,611.53
|
| Rate for Payer: BCN Medicare Advantage |
$991.31
|
| Rate for Payer: Cash Price |
$3,423.20
|
| Rate for Payer: Cash Price |
$3,423.20
|
| Rate for Payer: Cofinity Commercial |
$1,328.36
|
| Rate for Payer: Cofinity Commercial |
$1,427.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$991.31
|
| Rate for Payer: Healthscope Commercial |
$1,189.57
|
| Rate for Payer: Healthscope Whirlpool |
$1,189.57
|
| Rate for Payer: Meridian Medicaid |
$676.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,040.88
|
| Rate for Payer: PACE SWMI |
$991.31
|
| Rate for Payer: PHP Medicare Advantage |
$991.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$644.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,995.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,695.84
|
| Rate for Payer: Priority Health Medicare |
$991.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,695.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,021.05
|
|
|
PR CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL PRQ X LAM
|
Professional
|
Both
|
$2,356.00
|
|
|
Service Code
|
HCPCS 63741
|
| Min. Negotiated Rate |
$248.83 |
| Max. Negotiated Rate |
$1,649.20 |
| Rate for Payer: Aetna Commercial |
$923.05
|
| Rate for Payer: Aetna Medicare |
$688.84
|
| Rate for Payer: BCBS Complete |
$466.98
|
| Rate for Payer: BCBS MAPPO |
$688.84
|
| Rate for Payer: BCBS Trust/PPO |
$248.83
|
| Rate for Payer: BCN Commercial |
$1,017.92
|
| Rate for Payer: BCN Medicare Advantage |
$688.84
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cash Price |
$1,884.80
|
| Rate for Payer: Cofinity Commercial |
$991.93
|
| Rate for Payer: Cofinity Commercial |
$923.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$688.84
|
| Rate for Payer: Healthscope Commercial |
$826.61
|
| Rate for Payer: Healthscope Whirlpool |
$826.61
|
| Rate for Payer: Meridian Medicaid |
$466.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$723.28
|
| Rate for Payer: PACE SWMI |
$688.84
|
| Rate for Payer: PHP Medicare Advantage |
$688.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$444.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,649.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,179.44
|
| Rate for Payer: Priority Health Medicare |
$688.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,179.44
|
| Rate for Payer: UHC Medicare Advantage |
$709.51
|
|
|
PR CRTJ SHUNT SARACH/SDRL-PRTL-PLEURAL OTH
|
Professional
|
Both
|
$5,740.00
|
|
|
Service Code
|
HCPCS 62192
|
| Min. Negotiated Rate |
$478.64 |
| Max. Negotiated Rate |
$4,018.00 |
| Rate for Payer: Aetna Commercial |
$1,313.94
|
| Rate for Payer: Aetna Medicare |
$980.55
|
| Rate for Payer: BCBS Complete |
$681.02
|
| Rate for Payer: BCBS MAPPO |
$980.55
|
| Rate for Payer: BCBS Trust/PPO |
$478.64
|
| Rate for Payer: BCN Commercial |
$2,002.62
|
| Rate for Payer: BCN Medicare Advantage |
$980.55
|
| Rate for Payer: Cash Price |
$4,592.00
|
| Rate for Payer: Cash Price |
$4,592.00
|
| Rate for Payer: Cofinity Commercial |
$1,313.94
|
| Rate for Payer: Cofinity Commercial |
$1,411.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$980.55
|
| Rate for Payer: Healthscope Commercial |
$1,176.66
|
| Rate for Payer: Healthscope Whirlpool |
$1,176.66
|
| Rate for Payer: Meridian Medicaid |
$681.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,029.58
|
| Rate for Payer: PACE SWMI |
$980.55
|
| Rate for Payer: PHP Medicare Advantage |
$980.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$648.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,018.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,672.63
|
| Rate for Payer: Priority Health Medicare |
$980.55
|
| Rate for Payer: Priority Health Narrow Network |
$1,672.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,009.97
|
|
|
PR CRTJ SHUNT VENTRICULO-ATR-JUG-AUR
|
Professional
|
Both
|
$4,966.00
|
|
|
Service Code
|
HCPCS 62220
|
| Min. Negotiated Rate |
$633.46 |
| Max. Negotiated Rate |
$3,476.20 |
| Rate for Payer: Aetna Commercial |
$1,306.16
|
| Rate for Payer: Aetna Medicare |
$974.75
|
| Rate for Payer: BCBS Complete |
$665.13
|
| Rate for Payer: BCBS MAPPO |
$974.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,359.32
|
| Rate for Payer: BCN Commercial |
$1,984.31
|
| Rate for Payer: BCN Medicare Advantage |
$974.75
|
| Rate for Payer: Cash Price |
$3,972.80
|
| Rate for Payer: Cash Price |
$3,972.80
|
| Rate for Payer: Cofinity Commercial |
$1,306.16
|
| Rate for Payer: Cofinity Commercial |
$1,403.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$974.75
|
| Rate for Payer: Healthscope Commercial |
$1,169.70
|
| Rate for Payer: Healthscope Whirlpool |
$1,169.70
|
| Rate for Payer: Meridian Medicaid |
$665.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,023.49
|
| Rate for Payer: PACE SWMI |
$974.75
|
| Rate for Payer: PHP Medicare Advantage |
$974.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$633.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,476.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,657.34
|
| Rate for Payer: Priority Health Medicare |
$974.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,657.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,003.99
|
|
|
PR CRTJ SHUNT VENTRICULO-PERITNEAL-PLEURAL TERMINUS
|
Professional
|
Both
|
$4,952.00
|
|
|
Service Code
|
HCPCS 62223
|
| Min. Negotiated Rate |
$672.23 |
| Max. Negotiated Rate |
$3,466.40 |
| Rate for Payer: Aetna Commercial |
$1,392.42
|
| Rate for Payer: Aetna Medicare |
$1,039.12
|
| Rate for Payer: BCBS Complete |
$705.84
|
| Rate for Payer: BCBS MAPPO |
$1,039.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,466.56
|
| Rate for Payer: BCN Commercial |
$2,125.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,039.12
|
| Rate for Payer: Cash Price |
$3,961.60
|
| Rate for Payer: Cash Price |
$3,961.60
|
| Rate for Payer: Cofinity Commercial |
$1,392.42
|
| Rate for Payer: Cofinity Commercial |
$1,496.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,039.12
|
| Rate for Payer: Healthscope Commercial |
$1,246.94
|
| Rate for Payer: Healthscope Whirlpool |
$1,246.94
|
| Rate for Payer: Meridian Medicaid |
$705.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,091.08
|
| Rate for Payer: PACE SWMI |
$1,039.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,039.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$672.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,466.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,775.67
|
| Rate for Payer: Priority Health Medicare |
$1,039.12
|
| Rate for Payer: Priority Health Narrow Network |
$1,775.67
|
| Rate for Payer: UHC Medicare Advantage |
$1,070.29
|
|
|
PR CRX RPR DURAL/CSF LEAK RHINORRHEA/OTORRHEA
|
Professional
|
Both
|
$7,105.00
|
|
|
Service Code
|
HCPCS 62100
|
| Min. Negotiated Rate |
$1,018.35 |
| Max. Negotiated Rate |
$4,973.50 |
| Rate for Payer: Aetna Commercial |
$2,110.94
|
| Rate for Payer: Aetna Medicare |
$1,575.33
|
| Rate for Payer: BCBS Complete |
$1,069.27
|
| Rate for Payer: BCBS MAPPO |
$1,575.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,294.41
|
| Rate for Payer: BCN Commercial |
$3,210.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,575.33
|
| Rate for Payer: Cash Price |
$5,684.00
|
| Rate for Payer: Cash Price |
$5,684.00
|
| Rate for Payer: Cofinity Commercial |
$2,268.48
|
| Rate for Payer: Cofinity Commercial |
$2,110.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,575.33
|
| Rate for Payer: Healthscope Commercial |
$1,890.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,890.40
|
| Rate for Payer: Meridian Medicaid |
$1,069.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,654.10
|
| Rate for Payer: PACE SWMI |
$1,575.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,575.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,018.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,973.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,681.07
|
| Rate for Payer: Priority Health Medicare |
$1,575.33
|
| Rate for Payer: Priority Health Narrow Network |
$2,681.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,622.59
|
|
|
PR CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI
|
Professional
|
Both
|
$2,027.00
|
|
|
Service Code
|
HCPCS 55873
|
| Min. Negotiated Rate |
$486.49 |
| Max. Negotiated Rate |
$8,449.24 |
| Rate for Payer: Aetna Commercial |
$1,000.27
|
| Rate for Payer: Aetna Medicare |
$746.47
|
| Rate for Payer: BCBS Complete |
$510.81
|
| Rate for Payer: BCBS MAPPO |
$746.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,980.07
|
| Rate for Payer: BCN Commercial |
$8,449.24
|
| Rate for Payer: BCN Medicare Advantage |
$746.47
|
| Rate for Payer: Cash Price |
$1,621.60
|
| Rate for Payer: Cash Price |
$1,621.60
|
| Rate for Payer: Cofinity Commercial |
$1,074.92
|
| Rate for Payer: Cofinity Commercial |
$1,000.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$746.47
|
| Rate for Payer: Healthscope Commercial |
$895.76
|
| Rate for Payer: Healthscope Whirlpool |
$895.76
|
| Rate for Payer: Meridian Medicaid |
$510.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$783.79
|
| Rate for Payer: PACE SWMI |
$746.47
|
| Rate for Payer: PHP Medicare Advantage |
$746.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$486.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,418.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,219.05
|
| Rate for Payer: Priority Health Medicare |
$746.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,219.05
|
| Rate for Payer: UHC Medicare Advantage |
$768.86
|
|
|
PR CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE
|
Professional
|
Both
|
$101.00
|
|
|
Service Code
|
HCPCS 17340
|
| Min. Negotiated Rate |
$31.31 |
| Max. Negotiated Rate |
$145.43 |
| Rate for Payer: Aetna Commercial |
$64.67
|
| Rate for Payer: Aetna Medicare |
$48.26
|
| Rate for Payer: BCBS Complete |
$32.88
|
| Rate for Payer: BCBS MAPPO |
$48.26
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$76.72
|
| Rate for Payer: BCN Medicare Advantage |
$48.26
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$69.49
|
| Rate for Payer: Cofinity Commercial |
$64.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.26
|
| Rate for Payer: Healthscope Commercial |
$57.91
|
| Rate for Payer: Healthscope Whirlpool |
$57.91
|
| Rate for Payer: Meridian Medicaid |
$32.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.67
|
| Rate for Payer: PACE SWMI |
$48.26
|
| Rate for Payer: PHP Medicare Advantage |
$48.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.42
|
| Rate for Payer: Priority Health Medicare |
$48.26
|
| Rate for Payer: Priority Health Narrow Network |
$60.42
|
| Rate for Payer: UHC Medicare Advantage |
$49.71
|
|
|
PR CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC
|
Professional
|
Both
|
$4,470.58
|
|
|
Service Code
|
HCPCS 51595
|
| Min. Negotiated Rate |
$1,378.75 |
| Max. Negotiated Rate |
$3,462.61 |
| Rate for Payer: Aetna Commercial |
$2,855.20
|
| Rate for Payer: Aetna Medicare |
$2,130.75
|
| Rate for Payer: BCBS Complete |
$1,447.69
|
| Rate for Payer: BCBS MAPPO |
$2,130.75
|
| Rate for Payer: BCBS Trust/PPO |
$2,019.16
|
| Rate for Payer: BCN Commercial |
$3,131.45
|
| Rate for Payer: BCN Medicare Advantage |
$2,130.75
|
| Rate for Payer: Cash Price |
$3,576.46
|
| Rate for Payer: Cash Price |
$3,576.46
|
| Rate for Payer: Cofinity Commercial |
$2,855.20
|
| Rate for Payer: Cofinity Commercial |
$3,068.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,130.75
|
| Rate for Payer: Healthscope Commercial |
$2,556.90
|
| Rate for Payer: Healthscope Whirlpool |
$2,556.90
|
| Rate for Payer: Meridian Medicaid |
$1,447.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,237.29
|
| Rate for Payer: PACE SWMI |
$2,130.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,130.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,378.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,129.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,462.61
|
| Rate for Payer: Priority Health Medicare |
$2,130.75
|
| Rate for Payer: Priority Health Narrow Network |
$3,462.61
|
| Rate for Payer: UHC Medicare Advantage |
$2,194.67
|
|
|
PR CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR
|
Professional
|
Both
|
$4,810.00
|
|
|
Service Code
|
HCPCS 51596
|
| Min. Negotiated Rate |
$1,485.89 |
| Max. Negotiated Rate |
$3,738.20 |
| Rate for Payer: Aetna Commercial |
$3,081.58
|
| Rate for Payer: Aetna Medicare |
$2,299.69
|
| Rate for Payer: BCBS Complete |
$1,560.18
|
| Rate for Payer: BCBS MAPPO |
$2,299.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,189.80
|
| Rate for Payer: BCN Commercial |
$3,380.67
|
| Rate for Payer: BCN Medicare Advantage |
$2,299.69
|
| Rate for Payer: Cash Price |
$3,848.00
|
| Rate for Payer: Cash Price |
$3,848.00
|
| Rate for Payer: Cofinity Commercial |
$3,311.55
|
| Rate for Payer: Cofinity Commercial |
$3,081.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,299.69
|
| Rate for Payer: Healthscope Commercial |
$2,759.63
|
| Rate for Payer: Healthscope Whirlpool |
$2,759.63
|
| Rate for Payer: Meridian Medicaid |
$1,560.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,414.67
|
| Rate for Payer: PACE SWMI |
$2,299.69
|
| Rate for Payer: PHP Medicare Advantage |
$2,299.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,485.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,367.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,738.20
|
| Rate for Payer: Priority Health Medicare |
$2,299.69
|
| Rate for Payer: Priority Health Narrow Network |
$3,738.20
|
| Rate for Payer: UHC Medicare Advantage |
$2,368.68
|
|
|
PR CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST
|
Professional
|
Both
|
$4,815.00
|
|
|
Service Code
|
HCPCS 51590
|
| Min. Negotiated Rate |
$1,217.93 |
| Max. Negotiated Rate |
$3,370.50 |
| Rate for Payer: Aetna Commercial |
$2,522.66
|
| Rate for Payer: Aetna Medicare |
$1,882.58
|
| Rate for Payer: BCBS Complete |
$1,278.83
|
| Rate for Payer: BCBS MAPPO |
$1,882.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,561.73
|
| Rate for Payer: BCN Commercial |
$2,767.38
|
| Rate for Payer: BCN Medicare Advantage |
$1,882.58
|
| Rate for Payer: Cash Price |
$3,852.00
|
| Rate for Payer: Cash Price |
$3,852.00
|
| Rate for Payer: Cofinity Commercial |
$2,710.92
|
| Rate for Payer: Cofinity Commercial |
$2,522.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,882.58
|
| Rate for Payer: Healthscope Commercial |
$2,259.10
|
| Rate for Payer: Healthscope Whirlpool |
$2,259.10
|
| Rate for Payer: Meridian Medicaid |
$1,278.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,976.71
|
| Rate for Payer: PACE SWMI |
$1,882.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,882.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,217.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,370.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,060.04
|
| Rate for Payer: Priority Health Medicare |
$1,882.58
|
| Rate for Payer: Priority Health Narrow Network |
$3,060.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,939.06
|
|
|
PR CSTOPLASTY/CSTOURTP PLSTC ANY
|
Professional
|
Both
|
$1,113.00
|
|
|
Service Code
|
HCPCS 51800
|
| Min. Negotiated Rate |
$658.17 |
| Max. Negotiated Rate |
$3,574.48 |
| Rate for Payer: Aetna Commercial |
$1,357.46
|
| Rate for Payer: Aetna Medicare |
$1,013.03
|
| Rate for Payer: BCBS Complete |
$691.08
|
| Rate for Payer: BCBS MAPPO |
$1,013.03
|
| Rate for Payer: BCBS Trust/PPO |
$3,574.48
|
| Rate for Payer: BCN Commercial |
$1,493.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,013.03
|
| Rate for Payer: Cash Price |
$890.40
|
| Rate for Payer: Cash Price |
$890.40
|
| Rate for Payer: Cofinity Commercial |
$1,357.46
|
| Rate for Payer: Cofinity Commercial |
$1,458.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,013.03
|
| Rate for Payer: Healthscope Commercial |
$1,215.64
|
| Rate for Payer: Healthscope Whirlpool |
$1,215.64
|
| Rate for Payer: Meridian Medicaid |
$691.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,063.68
|
| Rate for Payer: PACE SWMI |
$1,013.03
|
| Rate for Payer: PHP Medicare Advantage |
$1,013.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$658.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$779.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,651.33
|
| Rate for Payer: Priority Health Medicare |
$1,013.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,651.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,043.42
|
|
|
PR CSTOURTP W/UNI/BI URTRONEOCSTOST
|
Professional
|
Both
|
$2,370.00
|
|
|
Service Code
|
HCPCS 51820
|
| Min. Negotiated Rate |
$688.20 |
| Max. Negotiated Rate |
$4,989.27 |
| Rate for Payer: Aetna Commercial |
$1,418.32
|
| Rate for Payer: Aetna Medicare |
$1,058.45
|
| Rate for Payer: BCBS Complete |
$722.61
|
| Rate for Payer: BCBS MAPPO |
$1,058.45
|
| Rate for Payer: BCBS Trust/PPO |
$4,989.27
|
| Rate for Payer: BCN Commercial |
$1,561.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,058.45
|
| Rate for Payer: Cash Price |
$1,896.00
|
| Rate for Payer: Cash Price |
$1,896.00
|
| Rate for Payer: Cofinity Commercial |
$1,418.32
|
| Rate for Payer: Cofinity Commercial |
$1,524.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,058.45
|
| Rate for Payer: Healthscope Commercial |
$1,270.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,270.14
|
| Rate for Payer: Meridian Medicaid |
$722.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,111.37
|
| Rate for Payer: PACE SWMI |
$1,058.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,058.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$688.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,659.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,726.45
|
| Rate for Payer: Priority Health Medicare |
$1,058.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,726.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,090.20
|
|
|
PR CTRL NASOPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ
|
Professional
|
Both
|
$919.00
|
|
|
Service Code
|
HCPCS 42972
|
| Min. Negotiated Rate |
$252.53 |
| Max. Negotiated Rate |
$896.66 |
| Rate for Payer: Aetna Commercial |
$669.62
|
| Rate for Payer: Aetna Medicare |
$499.72
|
| Rate for Payer: BCBS Complete |
$343.08
|
| Rate for Payer: BCBS MAPPO |
$499.72
|
| Rate for Payer: BCBS Trust/PPO |
$252.53
|
| Rate for Payer: BCN Commercial |
$745.24
|
| Rate for Payer: BCN Medicare Advantage |
$499.72
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cofinity Commercial |
$669.62
|
| Rate for Payer: Cofinity Commercial |
$719.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$499.72
|
| Rate for Payer: Healthscope Commercial |
$599.66
|
| Rate for Payer: Healthscope Whirlpool |
$599.66
|
| Rate for Payer: Meridian Medicaid |
$343.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$524.71
|
| Rate for Payer: PACE SWMI |
$499.72
|
| Rate for Payer: PHP Medicare Advantage |
$499.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$643.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$896.66
|
| Rate for Payer: Priority Health Medicare |
$499.72
|
| Rate for Payer: Priority Health Narrow Network |
$896.66
|
| Rate for Payer: UHC Medicare Advantage |
$514.71
|
|
|
PR CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS
|
Professional
|
Both
|
$734.00
|
|
|
Service Code
|
HCPCS 42970
|
| Min. Negotiated Rate |
$265.61 |
| Max. Negotiated Rate |
$727.90 |
| Rate for Payer: Aetna Commercial |
$541.79
|
| Rate for Payer: Aetna Medicare |
$404.32
|
| Rate for Payer: BCBS Complete |
$278.89
|
| Rate for Payer: BCBS MAPPO |
$404.32
|
| Rate for Payer: BCBS Trust/PPO |
$313.28
|
| Rate for Payer: BCN Commercial |
$604.99
|
| Rate for Payer: BCN Medicare Advantage |
$404.32
|
| Rate for Payer: Cash Price |
$587.20
|
| Rate for Payer: Cash Price |
$587.20
|
| Rate for Payer: Cofinity Commercial |
$541.79
|
| Rate for Payer: Cofinity Commercial |
$582.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$404.32
|
| Rate for Payer: Healthscope Commercial |
$485.18
|
| Rate for Payer: Healthscope Whirlpool |
$485.18
|
| Rate for Payer: Meridian Medicaid |
$278.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$424.54
|
| Rate for Payer: PACE SWMI |
$404.32
|
| Rate for Payer: PHP Medicare Advantage |
$404.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$513.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$727.90
|
| Rate for Payer: Priority Health Medicare |
$404.32
|
| Rate for Payer: Priority Health Narrow Network |
$727.90
|
| Rate for Payer: UHC Medicare Advantage |
$416.45
|
|
|
PR CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST
|
Professional
|
Both
|
$438.00
|
|
|
Service Code
|
HCPCS 30905
|
| Min. Negotiated Rate |
$67.31 |
| Max. Negotiated Rate |
$835.24 |
| Rate for Payer: Aetna Commercial |
$141.30
|
| Rate for Payer: Aetna Medicare |
$105.45
|
| Rate for Payer: BCBS Complete |
$70.68
|
| Rate for Payer: BCBS MAPPO |
$105.45
|
| Rate for Payer: BCBS Trust/PPO |
$835.24
|
| Rate for Payer: BCN Commercial |
$519.95
|
| Rate for Payer: BCN Medicare Advantage |
$105.45
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cash Price |
$350.40
|
| Rate for Payer: Cofinity Commercial |
$151.85
|
| Rate for Payer: Cofinity Commercial |
$141.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.45
|
| Rate for Payer: Healthscope Commercial |
$126.54
|
| Rate for Payer: Healthscope Whirlpool |
$126.54
|
| Rate for Payer: Meridian Medicaid |
$70.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$110.72
|
| Rate for Payer: PACE SWMI |
$105.45
|
| Rate for Payer: PHP Medicare Advantage |
$105.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$306.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.32
|
| Rate for Payer: Priority Health Medicare |
$105.45
|
| Rate for Payer: Priority Health Narrow Network |
$146.32
|
| Rate for Payer: UHC Medicare Advantage |
$108.61
|
|
|
PR CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ
|
Professional
|
Both
|
$587.00
|
|
|
Service Code
|
HCPCS 30906
|
| Min. Negotiated Rate |
$84.35 |
| Max. Negotiated Rate |
$907.62 |
| Rate for Payer: Aetna Commercial |
$176.97
|
| Rate for Payer: Aetna Medicare |
$132.07
|
| Rate for Payer: BCBS Complete |
$88.57
|
| Rate for Payer: BCBS MAPPO |
$132.07
|
| Rate for Payer: BCBS Trust/PPO |
$907.62
|
| Rate for Payer: BCN Commercial |
$551.23
|
| Rate for Payer: BCN Medicare Advantage |
$132.07
|
| Rate for Payer: Cash Price |
$469.60
|
| Rate for Payer: Cash Price |
$469.60
|
| Rate for Payer: Cofinity Commercial |
$176.97
|
| Rate for Payer: Cofinity Commercial |
$190.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.07
|
| Rate for Payer: Healthscope Commercial |
$158.48
|
| Rate for Payer: Healthscope Whirlpool |
$158.48
|
| Rate for Payer: Meridian Medicaid |
$88.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$138.67
|
| Rate for Payer: PACE SWMI |
$132.07
|
| Rate for Payer: PHP Medicare Advantage |
$132.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$183.83
|
| Rate for Payer: Priority Health Medicare |
$132.07
|
| Rate for Payer: Priority Health Narrow Network |
$183.83
|
| Rate for Payer: UHC Medicare Advantage |
$136.03
|
|
|
PR CTRL OROPHARYNGEAL HEMORRHAGE COMP REQ HOSPITJ
|
Professional
|
Both
|
$765.00
|
|
|
Service Code
|
HCPCS 42961
|
| Min. Negotiated Rate |
$269.96 |
| Max. Negotiated Rate |
$742.62 |
| Rate for Payer: Aetna Commercial |
$551.93
|
| Rate for Payer: Aetna Medicare |
$411.89
|
| Rate for Payer: BCBS Complete |
$284.49
|
| Rate for Payer: BCBS MAPPO |
$411.89
|
| Rate for Payer: BCBS Trust/PPO |
$269.96
|
| Rate for Payer: BCN Commercial |
$617.20
|
| Rate for Payer: BCN Medicare Advantage |
$411.89
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Cofinity Commercial |
$551.93
|
| Rate for Payer: Cofinity Commercial |
$593.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$411.89
|
| Rate for Payer: Healthscope Commercial |
$494.27
|
| Rate for Payer: Healthscope Whirlpool |
$494.27
|
| Rate for Payer: Meridian Medicaid |
$284.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$432.48
|
| Rate for Payer: PACE SWMI |
$411.89
|
| Rate for Payer: PHP Medicare Advantage |
$411.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$535.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$742.62
|
| Rate for Payer: Priority Health Medicare |
$411.89
|
| Rate for Payer: Priority Health Narrow Network |
$742.62
|
| Rate for Payer: UHC Medicare Advantage |
$424.25
|
|
|
PR CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ
|
Professional
|
Both
|
$1,864.00
|
|
|
Service Code
|
HCPCS 42962
|
| Min. Negotiated Rate |
$333.56 |
| Max. Negotiated Rate |
$1,304.80 |
| Rate for Payer: Aetna Commercial |
$684.00
|
| Rate for Payer: Aetna Medicare |
$510.45
|
| Rate for Payer: BCBS Complete |
$350.24
|
| Rate for Payer: BCBS MAPPO |
$510.45
|
| Rate for Payer: BCBS Trust/PPO |
$346.04
|
| Rate for Payer: BCN Commercial |
$763.31
|
| Rate for Payer: BCN Medicare Advantage |
$510.45
|
| Rate for Payer: Cash Price |
$1,491.20
|
| Rate for Payer: Cash Price |
$1,491.20
|
| Rate for Payer: Cofinity Commercial |
$735.05
|
| Rate for Payer: Cofinity Commercial |
$684.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.45
|
| Rate for Payer: Healthscope Commercial |
$612.54
|
| Rate for Payer: Healthscope Whirlpool |
$612.54
|
| Rate for Payer: Meridian Medicaid |
$350.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$535.97
|
| Rate for Payer: PACE SWMI |
$510.45
|
| Rate for Payer: PHP Medicare Advantage |
$510.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,304.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$918.42
|
| Rate for Payer: Priority Health Medicare |
$510.45
|
| Rate for Payer: Priority Health Narrow Network |
$918.42
|
| Rate for Payer: UHC Medicare Advantage |
$525.76
|
|
|
PR CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS
|
Professional
|
Both
|
$528.00
|
|
|
Service Code
|
HCPCS 95929
|
| Min. Negotiated Rate |
$111.47 |
| Max. Negotiated Rate |
$369.60 |
| Rate for Payer: Aetna Commercial |
$302.44
|
| Rate for Payer: Aetna Medicare |
$225.70
|
| Rate for Payer: BCBS Complete |
$211.20
|
| Rate for Payer: BCBS MAPPO |
$225.70
|
| Rate for Payer: BCBS Trust/PPO |
$111.47
|
| Rate for Payer: BCN Commercial |
$349.40
|
| Rate for Payer: BCN Medicare Advantage |
$225.70
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cash Price |
$422.40
|
| Rate for Payer: Cofinity Commercial |
$325.01
|
| Rate for Payer: Cofinity Commercial |
$302.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.70
|
| Rate for Payer: Healthscope Commercial |
$270.84
|
| Rate for Payer: Healthscope Whirlpool |
$270.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$236.98
|
| Rate for Payer: PACE SWMI |
$225.70
|
| Rate for Payer: PHP Medicare Advantage |
$225.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$369.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$321.13
|
| Rate for Payer: Priority Health Medicare |
$225.70
|
| Rate for Payer: Priority Health Narrow Network |
$321.13
|
| Rate for Payer: UHC Medicare Advantage |
$232.47
|
|
