|
PR DECOMPRESSION FINGERS&/HAND INJECTION INJURY
|
Professional
|
Both
|
$2,143.00
|
|
|
Service Code
|
HCPCS 26035
|
| Min. Negotiated Rate |
$89.15 |
| Max. Negotiated Rate |
$1,500.10 |
| Rate for Payer: Aetna Commercial |
$1,136.59
|
| Rate for Payer: Aetna Medicare |
$848.20
|
| Rate for Payer: BCBS Complete |
$585.96
|
| Rate for Payer: BCBS MAPPO |
$848.20
|
| Rate for Payer: BCBS Trust/PPO |
$89.15
|
| Rate for Payer: BCN Commercial |
$1,268.12
|
| Rate for Payer: BCN Medicare Advantage |
$848.20
|
| Rate for Payer: Cash Price |
$1,714.40
|
| Rate for Payer: Cash Price |
$1,714.40
|
| Rate for Payer: Cofinity Commercial |
$1,221.41
|
| Rate for Payer: Cofinity Commercial |
$1,136.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$848.20
|
| Rate for Payer: Healthscope Commercial |
$1,017.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,017.84
|
| Rate for Payer: Meridian Medicaid |
$585.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$890.61
|
| Rate for Payer: PACE SWMI |
$848.20
|
| Rate for Payer: PHP Medicare Advantage |
$848.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$558.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,500.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,325.13
|
| Rate for Payer: Priority Health Medicare |
$848.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,325.13
|
| Rate for Payer: UHC Medicare Advantage |
$873.65
|
|
|
PR DECOMPRESSION ORBIT ONLY TRANSCRANIAL APPROACH
|
Professional
|
Both
|
$5,633.00
|
|
|
Service Code
|
HCPCS 61330
|
| Min. Negotiated Rate |
$322.79 |
| Max. Negotiated Rate |
$3,943.10 |
| Rate for Payer: Aetna Commercial |
$2,421.09
|
| Rate for Payer: Aetna Medicare |
$1,806.78
|
| Rate for Payer: BCBS Complete |
$1,223.82
|
| Rate for Payer: BCBS MAPPO |
$1,806.78
|
| Rate for Payer: BCBS Trust/PPO |
$322.79
|
| Rate for Payer: BCN Commercial |
$2,648.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,806.78
|
| Rate for Payer: Cash Price |
$4,506.40
|
| Rate for Payer: Cash Price |
$4,506.40
|
| Rate for Payer: Cofinity Commercial |
$2,601.76
|
| Rate for Payer: Cofinity Commercial |
$2,421.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,806.78
|
| Rate for Payer: Healthscope Commercial |
$2,168.14
|
| Rate for Payer: Healthscope Whirlpool |
$2,168.14
|
| Rate for Payer: Meridian Medicaid |
$1,223.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,897.12
|
| Rate for Payer: PACE SWMI |
$1,806.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,806.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,165.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,943.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,068.94
|
| Rate for Payer: Priority Health Medicare |
$1,806.78
|
| Rate for Payer: Priority Health Narrow Network |
$3,068.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,860.98
|
|
|
PR DECOMPRESSION PLANTAR DIGITAL NERVE
|
Professional
|
Both
|
$1,542.00
|
|
|
Service Code
|
HCPCS 64726
|
| Min. Negotiated Rate |
$173.17 |
| Max. Negotiated Rate |
$1,254.71 |
| Rate for Payer: Aetna Commercial |
$353.53
|
| Rate for Payer: Aetna Medicare |
$263.83
|
| Rate for Payer: BCBS Complete |
$181.83
|
| Rate for Payer: BCBS MAPPO |
$263.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,254.71
|
| Rate for Payer: BCN Commercial |
$393.87
|
| Rate for Payer: BCN Medicare Advantage |
$263.83
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cash Price |
$1,233.60
|
| Rate for Payer: Cofinity Commercial |
$353.53
|
| Rate for Payer: Cofinity Commercial |
$379.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.83
|
| Rate for Payer: Healthscope Commercial |
$316.60
|
| Rate for Payer: Healthscope Whirlpool |
$316.60
|
| Rate for Payer: Meridian Medicaid |
$181.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$277.02
|
| Rate for Payer: PACE SWMI |
$263.83
|
| Rate for Payer: PHP Medicare Advantage |
$263.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,079.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.37
|
| Rate for Payer: Priority Health Medicare |
$263.83
|
| Rate for Payer: Priority Health Narrow Network |
$456.37
|
| Rate for Payer: UHC Medicare Advantage |
$271.74
|
|
|
PR DECOMPRESSION UNSPECIFIED NERVE
|
Professional
|
Both
|
$1,748.00
|
|
|
Service Code
|
HCPCS 64722
|
| Min. Negotiated Rate |
$240.69 |
| Max. Negotiated Rate |
$5,909.56 |
| Rate for Payer: Aetna Commercial |
$482.01
|
| Rate for Payer: Aetna Medicare |
$359.71
|
| Rate for Payer: BCBS Complete |
$252.72
|
| Rate for Payer: BCBS MAPPO |
$359.71
|
| Rate for Payer: BCBS Trust/PPO |
$5,909.56
|
| Rate for Payer: BCN Commercial |
$537.55
|
| Rate for Payer: BCN Medicare Advantage |
$359.71
|
| Rate for Payer: Cash Price |
$1,398.40
|
| Rate for Payer: Cash Price |
$1,398.40
|
| Rate for Payer: Cofinity Commercial |
$517.98
|
| Rate for Payer: Cofinity Commercial |
$482.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$359.71
|
| Rate for Payer: Healthscope Commercial |
$431.65
|
| Rate for Payer: Healthscope Whirlpool |
$431.65
|
| Rate for Payer: Meridian Medicaid |
$252.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$377.70
|
| Rate for Payer: PACE SWMI |
$359.71
|
| Rate for Payer: PHP Medicare Advantage |
$359.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,223.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$622.85
|
| Rate for Payer: Priority Health Medicare |
$359.71
|
| Rate for Payer: Priority Health Narrow Network |
$622.85
|
| Rate for Payer: UHC Medicare Advantage |
$370.50
|
|
|
PR DECOMPRESSIVE FASCIOTOMY HAND
|
Professional
|
Both
|
$1,336.00
|
|
|
Service Code
|
HCPCS 26037
|
| Min. Negotiated Rate |
$109.10 |
| Max. Negotiated Rate |
$935.20 |
| Rate for Payer: Aetna Commercial |
$743.87
|
| Rate for Payer: Aetna Medicare |
$555.13
|
| Rate for Payer: BCBS Complete |
$383.11
|
| Rate for Payer: BCBS MAPPO |
$555.13
|
| Rate for Payer: BCBS Trust/PPO |
$109.10
|
| Rate for Payer: BCN Commercial |
$829.77
|
| Rate for Payer: BCN Medicare Advantage |
$555.13
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cash Price |
$1,068.80
|
| Rate for Payer: Cofinity Commercial |
$743.87
|
| Rate for Payer: Cofinity Commercial |
$799.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$555.13
|
| Rate for Payer: Healthscope Commercial |
$666.16
|
| Rate for Payer: Healthscope Whirlpool |
$666.16
|
| Rate for Payer: Meridian Medicaid |
$383.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$582.89
|
| Rate for Payer: PACE SWMI |
$555.13
|
| Rate for Payer: PHP Medicare Advantage |
$555.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$364.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$935.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$867.08
|
| Rate for Payer: Priority Health Medicare |
$555.13
|
| Rate for Payer: Priority Health Narrow Network |
$867.08
|
| Rate for Payer: UHC Medicare Advantage |
$571.78
|
|
|
PR DECORTICATION & PARIETAL PLEURECTOMY
|
Professional
|
Both
|
$3,934.00
|
|
|
Service Code
|
HCPCS 32320
|
| Min. Negotiated Rate |
$518.79 |
| Max. Negotiated Rate |
$2,753.80 |
| Rate for Payer: Aetna Commercial |
$2,117.51
|
| Rate for Payer: Aetna Medicare |
$1,580.23
|
| Rate for Payer: BCBS Complete |
$1,063.68
|
| Rate for Payer: BCBS MAPPO |
$1,580.23
|
| Rate for Payer: BCBS Trust/PPO |
$518.79
|
| Rate for Payer: BCN Commercial |
$2,313.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.23
|
| Rate for Payer: Cash Price |
$3,147.20
|
| Rate for Payer: Cash Price |
$3,147.20
|
| Rate for Payer: Cofinity Commercial |
$2,275.53
|
| Rate for Payer: Cofinity Commercial |
$2,117.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.23
|
| Rate for Payer: Healthscope Commercial |
$1,896.28
|
| Rate for Payer: Healthscope Whirlpool |
$1,896.28
|
| Rate for Payer: Meridian Medicaid |
$1,063.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,659.24
|
| Rate for Payer: PACE SWMI |
$1,580.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,013.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,753.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,192.52
|
| Rate for Payer: Priority Health Medicare |
$1,580.23
|
| Rate for Payer: Priority Health Narrow Network |
$2,192.52
|
| Rate for Payer: UHC Medicare Advantage |
$1,627.64
|
|
|
PR DECORTICATION PULMONARY PARTIAL SEPARATE PROC
|
Professional
|
Both
|
$2,022.00
|
|
|
Service Code
|
HCPCS 32225
|
| Min. Negotiated Rate |
$468.07 |
| Max. Negotiated Rate |
$1,437.69 |
| Rate for Payer: Aetna Commercial |
$1,314.39
|
| Rate for Payer: Aetna Medicare |
$980.89
|
| Rate for Payer: BCBS Complete |
$660.22
|
| Rate for Payer: BCBS MAPPO |
$980.89
|
| Rate for Payer: BCBS Trust/PPO |
$468.07
|
| Rate for Payer: BCN Commercial |
$1,437.69
|
| Rate for Payer: BCN Medicare Advantage |
$980.89
|
| Rate for Payer: Cash Price |
$1,617.60
|
| Rate for Payer: Cash Price |
$1,617.60
|
| Rate for Payer: Cofinity Commercial |
$1,412.48
|
| Rate for Payer: Cofinity Commercial |
$1,314.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$980.89
|
| Rate for Payer: Healthscope Commercial |
$1,177.07
|
| Rate for Payer: Healthscope Whirlpool |
$1,177.07
|
| Rate for Payer: Meridian Medicaid |
$660.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,029.93
|
| Rate for Payer: PACE SWMI |
$980.89
|
| Rate for Payer: PHP Medicare Advantage |
$980.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$628.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,415.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,362.28
|
| Rate for Payer: Priority Health Medicare |
$980.89
|
| Rate for Payer: Priority Health Narrow Network |
$1,362.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,010.32
|
|
|
PR DECORTICATION PULMONARY TOTAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$2,905.00
|
|
|
Service Code
|
HCPCS 32220
|
| Min. Negotiated Rate |
$758.11 |
| Max. Negotiated Rate |
$2,302.65 |
| Rate for Payer: Aetna Commercial |
$2,104.30
|
| Rate for Payer: Aetna Medicare |
$1,570.37
|
| Rate for Payer: BCBS Complete |
$1,060.55
|
| Rate for Payer: BCBS MAPPO |
$1,570.37
|
| Rate for Payer: BCBS Trust/PPO |
$758.11
|
| Rate for Payer: BCN Commercial |
$2,302.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,570.37
|
| Rate for Payer: Cash Price |
$2,324.00
|
| Rate for Payer: Cash Price |
$2,324.00
|
| Rate for Payer: Cofinity Commercial |
$2,104.30
|
| Rate for Payer: Cofinity Commercial |
$2,261.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,570.37
|
| Rate for Payer: Healthscope Commercial |
$1,884.44
|
| Rate for Payer: Healthscope Whirlpool |
$1,884.44
|
| Rate for Payer: Meridian Medicaid |
$1,060.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,648.89
|
| Rate for Payer: PACE SWMI |
$1,570.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,570.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,010.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,181.86
|
| Rate for Payer: Priority Health Medicare |
$1,570.37
|
| Rate for Payer: Priority Health Narrow Network |
$2,181.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,617.48
|
|
|
PR DEGARELIX INJECTION
|
Professional
|
Both
|
$6.00
|
|
|
Service Code
|
HCPCS J9155
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$6.04 |
| Rate for Payer: Aetna Commercial |
$5.62
|
| Rate for Payer: Aetna Medicare |
$4.19
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCBS MAPPO |
$4.19
|
| Rate for Payer: BCBS Trust/PPO |
$4.18
|
| Rate for Payer: BCN Commercial |
$4.06
|
| Rate for Payer: BCN Medicare Advantage |
$4.19
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$6.04
|
| Rate for Payer: Cofinity Commercial |
$5.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.19
|
| Rate for Payer: Healthscope Commercial |
$5.03
|
| Rate for Payer: Healthscope Whirlpool |
$5.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.40
|
| Rate for Payer: PACE SWMI |
$4.19
|
| Rate for Payer: PHP Medicare Advantage |
$4.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.20
|
| Rate for Payer: Priority Health Medicare |
$4.19
|
| Rate for Payer: UHC Medicare Advantage |
$4.32
|
|
|
PR DELAYED CREATION EXIT SITE EMBEDDED CATHETER
|
Professional
|
Both
|
$1,265.00
|
|
|
Service Code
|
HCPCS 49436
|
| Min. Negotiated Rate |
$119.49 |
| Max. Negotiated Rate |
$2,493.58 |
| Rate for Payer: Aetna Commercial |
$245.94
|
| Rate for Payer: Aetna Medicare |
$183.54
|
| Rate for Payer: BCBS Complete |
$125.46
|
| Rate for Payer: BCBS MAPPO |
$183.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,493.58
|
| Rate for Payer: BCN Commercial |
$801.43
|
| Rate for Payer: BCN Medicare Advantage |
$183.54
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cash Price |
$1,012.00
|
| Rate for Payer: Cofinity Commercial |
$264.30
|
| Rate for Payer: Cofinity Commercial |
$245.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.54
|
| Rate for Payer: Healthscope Commercial |
$220.25
|
| Rate for Payer: Healthscope Whirlpool |
$220.25
|
| Rate for Payer: Meridian Medicaid |
$125.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$192.72
|
| Rate for Payer: PACE SWMI |
$183.54
|
| Rate for Payer: PHP Medicare Advantage |
$183.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$885.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$326.91
|
| Rate for Payer: Priority Health Medicare |
$183.54
|
| Rate for Payer: Priority Health Narrow Network |
$326.91
|
| Rate for Payer: UHC Medicare Advantage |
$189.05
|
|
|
PR DELAY FLAP/SCTJ FLAP EYELIDS NOSE EARS/LIPS
|
Professional
|
Both
|
$888.00
|
|
|
Service Code
|
HCPCS 15630
|
| Min. Negotiated Rate |
$221.09 |
| Max. Negotiated Rate |
$3,918.45 |
| Rate for Payer: Aetna Commercial |
$445.04
|
| Rate for Payer: Aetna Medicare |
$332.12
|
| Rate for Payer: BCBS Complete |
$232.14
|
| Rate for Payer: BCBS MAPPO |
$332.12
|
| Rate for Payer: BCBS Trust/PPO |
$3,918.45
|
| Rate for Payer: BCN Commercial |
$677.79
|
| Rate for Payer: BCN Medicare Advantage |
$332.12
|
| Rate for Payer: Cash Price |
$710.40
|
| Rate for Payer: Cash Price |
$710.40
|
| Rate for Payer: Cofinity Commercial |
$478.25
|
| Rate for Payer: Cofinity Commercial |
$445.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.12
|
| Rate for Payer: Healthscope Commercial |
$398.54
|
| Rate for Payer: Healthscope Whirlpool |
$398.54
|
| Rate for Payer: Meridian Medicaid |
$232.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$348.73
|
| Rate for Payer: PACE SWMI |
$332.12
|
| Rate for Payer: PHP Medicare Advantage |
$332.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$221.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$621.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$421.72
|
| Rate for Payer: Priority Health Medicare |
$332.12
|
| Rate for Payer: Priority Health Narrow Network |
$421.72
|
| Rate for Payer: UHC Medicare Advantage |
$342.08
|
|
|
PR DELAY FLAP/SECTIONING FLAP F/C/C/N/AX/G/H/F
|
Professional
|
Both
|
$710.00
|
|
|
Service Code
|
HCPCS 15620
|
| Min. Negotiated Rate |
$75.69 |
| Max. Negotiated Rate |
$657.27 |
| Rate for Payer: Aetna Commercial |
$423.65
|
| Rate for Payer: Aetna Medicare |
$316.16
|
| Rate for Payer: BCBS Complete |
$220.74
|
| Rate for Payer: BCBS MAPPO |
$316.16
|
| Rate for Payer: BCBS Trust/PPO |
$75.69
|
| Rate for Payer: BCN Commercial |
$657.27
|
| Rate for Payer: BCN Medicare Advantage |
$316.16
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cofinity Commercial |
$423.65
|
| Rate for Payer: Cofinity Commercial |
$455.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.16
|
| Rate for Payer: Healthscope Commercial |
$379.39
|
| Rate for Payer: Healthscope Whirlpool |
$379.39
|
| Rate for Payer: Meridian Medicaid |
$220.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$331.97
|
| Rate for Payer: PACE SWMI |
$316.16
|
| Rate for Payer: PHP Medicare Advantage |
$316.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$497.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$401.59
|
| Rate for Payer: Priority Health Medicare |
$316.16
|
| Rate for Payer: Priority Health Narrow Network |
$401.59
|
| Rate for Payer: UHC Medicare Advantage |
$325.64
|
|
|
PR DELAY FLAP/SECTIONING FLAP SCALP ARMS/LEGS
|
Professional
|
Both
|
$600.00
|
|
|
Service Code
|
HCPCS 15610
|
| Min. Negotiated Rate |
$157.62 |
| Max. Negotiated Rate |
$2,032.46 |
| Rate for Payer: Aetna Commercial |
$316.21
|
| Rate for Payer: Aetna Medicare |
$235.98
|
| Rate for Payer: BCBS Complete |
$165.50
|
| Rate for Payer: BCBS MAPPO |
$235.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,032.46
|
| Rate for Payer: BCN Commercial |
$541.46
|
| Rate for Payer: BCN Medicare Advantage |
$235.98
|
| Rate for Payer: Cash Price |
$480.00
|
| Rate for Payer: Cash Price |
$480.00
|
| Rate for Payer: Cofinity Commercial |
$339.81
|
| Rate for Payer: Cofinity Commercial |
$316.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.98
|
| Rate for Payer: Healthscope Commercial |
$283.18
|
| Rate for Payer: Healthscope Whirlpool |
$283.18
|
| Rate for Payer: Meridian Medicaid |
$165.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$247.78
|
| Rate for Payer: PACE SWMI |
$235.98
|
| Rate for Payer: PHP Medicare Advantage |
$235.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$300.88
|
| Rate for Payer: Priority Health Medicare |
$235.98
|
| Rate for Payer: Priority Health Narrow Network |
$300.88
|
| Rate for Payer: UHC Medicare Advantage |
$243.06
|
|
|
PR DELAY FLAP/SECTIONING FLAP TRUNK
|
Professional
|
Both
|
$519.00
|
|
|
Service Code
|
HCPCS 15600
|
| Min. Negotiated Rate |
$136.96 |
| Max. Negotiated Rate |
$852.18 |
| Rate for Payer: Aetna Commercial |
$273.09
|
| Rate for Payer: Aetna Medicare |
$203.80
|
| Rate for Payer: BCBS Complete |
$143.81
|
| Rate for Payer: BCBS MAPPO |
$203.80
|
| Rate for Payer: BCBS Trust/PPO |
$852.18
|
| Rate for Payer: BCN Commercial |
$497.47
|
| Rate for Payer: BCN Medicare Advantage |
$203.80
|
| Rate for Payer: Cash Price |
$415.20
|
| Rate for Payer: Cash Price |
$415.20
|
| Rate for Payer: Cofinity Commercial |
$273.09
|
| Rate for Payer: Cofinity Commercial |
$293.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.80
|
| Rate for Payer: Healthscope Commercial |
$244.56
|
| Rate for Payer: Healthscope Whirlpool |
$244.56
|
| Rate for Payer: Meridian Medicaid |
$143.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$213.99
|
| Rate for Payer: PACE SWMI |
$203.80
|
| Rate for Payer: PHP Medicare Advantage |
$203.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$260.59
|
| Rate for Payer: Priority Health Medicare |
$203.80
|
| Rate for Payer: Priority Health Narrow Network |
$260.59
|
| Rate for Payer: UHC Medicare Advantage |
$209.91
|
|
|
PR DELIVERY/BIRTHING ROOM RESUSCITATION
|
Professional
|
Both
|
$456.00
|
|
|
Service Code
|
HCPCS 99465
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$319.20 |
| Rate for Payer: Aetna Commercial |
$186.18
|
| Rate for Payer: Aetna Medicare |
$138.94
|
| Rate for Payer: BCBS Complete |
$94.15
|
| Rate for Payer: BCBS MAPPO |
$138.94
|
| Rate for Payer: BCBS Trust/PPO |
$115.04
|
| Rate for Payer: BCN Commercial |
$204.27
|
| Rate for Payer: BCN Medicare Advantage |
$138.94
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cofinity Commercial |
$200.07
|
| Rate for Payer: Cofinity Commercial |
$186.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.94
|
| Rate for Payer: Healthscope Commercial |
$152.83
|
| Rate for Payer: Healthscope Whirlpool |
$152.83
|
| Rate for Payer: Meridian Medicaid |
$94.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.89
|
| Rate for Payer: PACE SWMI |
$138.94
|
| Rate for Payer: PHP Medicare Advantage |
$138.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$319.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.04
|
| Rate for Payer: Priority Health Medicare |
$138.94
|
| Rate for Payer: Priority Health Narrow Network |
$179.04
|
| Rate for Payer: UHC Medicare Advantage |
$143.11
|
|
|
PR DELIVERY PLACENTA SEPARATE PROCEDURE
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 59414
|
| Min. Negotiated Rate |
$68.68 |
| Max. Negotiated Rate |
$177.80 |
| Rate for Payer: Aetna Commercial |
$122.13
|
| Rate for Payer: Aetna Medicare |
$91.14
|
| Rate for Payer: BCBS Complete |
$88.49
|
| Rate for Payer: BCBS MAPPO |
$91.14
|
| Rate for Payer: BCBS Trust/PPO |
$68.68
|
| Rate for Payer: BCN Commercial |
$132.43
|
| Rate for Payer: BCN Medicare Advantage |
$91.14
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$131.24
|
| Rate for Payer: Cofinity Commercial |
$122.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.14
|
| Rate for Payer: Healthscope Commercial |
$109.37
|
| Rate for Payer: Healthscope Whirlpool |
$109.37
|
| Rate for Payer: Meridian Medicaid |
$88.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$95.70
|
| Rate for Payer: PACE SWMI |
$91.14
|
| Rate for Payer: PHP Medicare Advantage |
$91.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.95
|
| Rate for Payer: Priority Health Medicare |
$91.14
|
| Rate for Payer: Priority Health Narrow Network |
$127.95
|
| Rate for Payer: UHC Medicare Advantage |
$93.87
|
|
|
PR DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 94664
|
| Min. Negotiated Rate |
$15.80 |
| Max. Negotiated Rate |
$379.32 |
| Rate for Payer: Aetna Commercial |
$21.17
|
| Rate for Payer: Aetna Medicare |
$15.80
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: BCBS MAPPO |
$15.80
|
| Rate for Payer: BCBS Trust/PPO |
$379.32
|
| Rate for Payer: BCN Commercial |
$24.92
|
| Rate for Payer: BCN Medicare Advantage |
$15.80
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$22.75
|
| Rate for Payer: Cofinity Commercial |
$21.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.80
|
| Rate for Payer: Healthscope Commercial |
$18.96
|
| Rate for Payer: Healthscope Whirlpool |
$18.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.59
|
| Rate for Payer: PACE SWMI |
$15.80
|
| Rate for Payer: PHP Medicare Advantage |
$15.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.90
|
| Rate for Payer: Priority Health Medicare |
$15.80
|
| Rate for Payer: Priority Health Narrow Network |
$22.90
|
| Rate for Payer: UHC Medicare Advantage |
$16.27
|
|
|
PR DENOSUMAB INJECTION
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS J0897
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$34.84 |
| Rate for Payer: Aetna Commercial |
$32.42
|
| Rate for Payer: Aetna Medicare |
$24.19
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: BCBS MAPPO |
$24.19
|
| Rate for Payer: BCBS Trust/PPO |
$24.59
|
| Rate for Payer: BCN Commercial |
$22.46
|
| Rate for Payer: BCN Medicare Advantage |
$24.19
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$34.84
|
| Rate for Payer: Cofinity Commercial |
$32.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.19
|
| Rate for Payer: Healthscope Commercial |
$29.03
|
| Rate for Payer: Healthscope Whirlpool |
$29.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.40
|
| Rate for Payer: PACE SWMI |
$24.19
|
| Rate for Payer: PHP Medicare Advantage |
$24.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health Medicare |
$24.19
|
| Rate for Payer: UHC Medicare Advantage |
$24.92
|
|
|
PR DEPO-ESTRADIOL CYPIONATE INJ
|
Professional
|
Both
|
$17.00
|
|
|
Service Code
|
HCPCS J1000
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$44.18 |
| Rate for Payer: Aetna Commercial |
$41.11
|
| Rate for Payer: Aetna Medicare |
$30.68
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: BCBS MAPPO |
$30.68
|
| Rate for Payer: BCBS Trust/PPO |
$36.42
|
| Rate for Payer: BCN Commercial |
$29.80
|
| Rate for Payer: BCN Medicare Advantage |
$30.68
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Cofinity Commercial |
$44.18
|
| Rate for Payer: Cofinity Commercial |
$41.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.68
|
| Rate for Payer: Healthscope Commercial |
$36.82
|
| Rate for Payer: Healthscope Whirlpool |
$36.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.22
|
| Rate for Payer: PACE SWMI |
$30.68
|
| Rate for Payer: PHP Medicare Advantage |
$30.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.90
|
| Rate for Payer: Priority Health Medicare |
$30.68
|
| Rate for Payer: UHC Medicare Advantage |
$31.60
|
|
|
PR DEPRESSION SCREEN ANNUAL
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS G0444
|
| Min. Negotiated Rate |
$8.93 |
| Max. Negotiated Rate |
$1,280.07 |
| Rate for Payer: Aetna Commercial |
$11.97
|
| Rate for Payer: Aetna Medicare |
$8.93
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,280.07
|
| Rate for Payer: BCN Commercial |
$26.88
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$12.86
|
| Rate for Payer: Cofinity Commercial |
$11.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$10.72
|
| Rate for Payer: Healthscope Whirlpool |
$10.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.80
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow Network |
$10.80
|
| Rate for Payer: UHC Medicare Advantage |
$9.20
|
|
|
PR DERMAGRAFT
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS Q4106
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$281.06 |
| Rate for Payer: Aetna Commercial |
$46.20
|
| Rate for Payer: Aetna Medicare |
$34.48
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS MAPPO |
$34.48
|
| Rate for Payer: BCBS Trust/PPO |
$281.06
|
| Rate for Payer: BCN Commercial |
$33.86
|
| Rate for Payer: BCN Medicare Advantage |
$34.48
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$49.65
|
| Rate for Payer: Cofinity Commercial |
$46.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.48
|
| Rate for Payer: Healthscope Commercial |
$41.37
|
| Rate for Payer: Healthscope Whirlpool |
$41.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.20
|
| Rate for Payer: PACE SWMI |
$34.48
|
| Rate for Payer: PHP Medicare Advantage |
$34.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
| Rate for Payer: Priority Health Medicare |
$34.48
|
| Rate for Payer: UHC Medicare Advantage |
$35.51
|
|
|
PR DERMAL AUTOGRAFT F/S/N/H/F/G/M/D GT 1ST 100
|
Professional
|
Both
|
$1,555.00
|
|
|
Service Code
|
HCPCS 15135
|
| Min. Negotiated Rate |
$116.11 |
| Max. Negotiated Rate |
$1,287.66 |
| Rate for Payer: Aetna Commercial |
$994.40
|
| Rate for Payer: Aetna Medicare |
$742.09
|
| Rate for Payer: BCBS Complete |
$508.36
|
| Rate for Payer: BCBS MAPPO |
$742.09
|
| Rate for Payer: BCBS Trust/PPO |
$116.11
|
| Rate for Payer: BCN Commercial |
$1,287.66
|
| Rate for Payer: BCN Medicare Advantage |
$742.09
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cash Price |
$1,244.00
|
| Rate for Payer: Cofinity Commercial |
$994.40
|
| Rate for Payer: Cofinity Commercial |
$1,068.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$742.09
|
| Rate for Payer: Healthscope Commercial |
$890.51
|
| Rate for Payer: Healthscope Whirlpool |
$890.51
|
| Rate for Payer: Meridian Medicaid |
$508.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$779.19
|
| Rate for Payer: PACE SWMI |
$742.09
|
| Rate for Payer: PHP Medicare Advantage |
$742.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,088.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$931.41
|
| Rate for Payer: Priority Health Medicare |
$742.09
|
| Rate for Payer: Priority Health Narrow Network |
$931.41
|
| Rate for Payer: UHC Medicare Advantage |
$764.35
|
|
|
PR DERMAL FILLER JUVEDERM ULTRA
|
Professional
|
Both
|
$675.00
|
|
|
Service Code
|
HCPCS 00087
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$270.00 |
| Max. Negotiated Rate |
$472.50 |
| Rate for Payer: BCBS Complete |
$270.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.50
|
|
|
PR DERMAL FILLER JUVEDERM ULTRA PR PLUS
|
Professional
|
Both
|
$400.00
|
|
|
Service Code
|
HCPCS 00089
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$280.00 |
| Rate for Payer: BCBS Complete |
$160.00
|
| Rate for Payer: Cash Price |
$320.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.00
|
|
|
PR DERMAL FILLER JUVEDERM ULTRA PR PLUS >1
|
Professional
|
Both
|
$675.00
|
|
|
Service Code
|
HCPCS 00090
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$270.00 |
| Max. Negotiated Rate |
$472.50 |
| Rate for Payer: BCBS Complete |
$270.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.50
|
|
