|
PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION
|
Facility
|
IP
|
$146.86
|
|
|
Service Code
|
NDC 61314-637-10
|
| Hospital Charge Code |
6487
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$102.80 |
| Max. Negotiated Rate |
$146.86 |
| Rate for Payer: Aetna Commercial |
$132.17
|
| Rate for Payer: ASR ASR |
$142.45
|
| Rate for Payer: BCBS Trust/PPO |
$113.86
|
| Rate for Payer: BCN Commercial |
$113.86
|
| Rate for Payer: Cash Price |
$117.49
|
| Rate for Payer: Cofinity Commercial |
$138.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.49
|
| Rate for Payer: Healthscope Commercial |
$146.86
|
| Rate for Payer: Healthscope Whirlpool |
$142.45
|
| Rate for Payer: Mclaren Commercial |
$132.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.24
|
|
|
PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION
|
Facility
|
IP
|
$845.84
|
|
|
Service Code
|
NDC 11980-180-10
|
| Hospital Charge Code |
6487
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$592.09 |
| Max. Negotiated Rate |
$845.84 |
| Rate for Payer: Aetna Commercial |
$761.26
|
| Rate for Payer: ASR ASR |
$820.46
|
| Rate for Payer: BCBS Trust/PPO |
$655.78
|
| Rate for Payer: BCN Commercial |
$655.78
|
| Rate for Payer: Cash Price |
$676.68
|
| Rate for Payer: Cofinity Commercial |
$795.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$676.67
|
| Rate for Payer: Healthscope Commercial |
$845.84
|
| Rate for Payer: Healthscope Whirlpool |
$820.46
|
| Rate for Payer: Mclaren Commercial |
$761.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$718.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$744.34
|
|
|
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION
|
Facility
|
IP
|
$774.16
|
|
|
Service Code
|
HCPCS J7510
|
| Hospital Charge Code |
29302
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$541.91 |
| Max. Negotiated Rate |
$774.16 |
| Rate for Payer: Aetna Commercial |
$696.74
|
| Rate for Payer: Aetna Commercial |
$17.24
|
| Rate for Payer: ASR ASR |
$18.58
|
| Rate for Payer: ASR ASR |
$750.94
|
| Rate for Payer: BCBS Trust/PPO |
$14.85
|
| Rate for Payer: BCBS Trust/PPO |
$600.21
|
| Rate for Payer: BCN Commercial |
$600.21
|
| Rate for Payer: BCN Commercial |
$14.85
|
| Rate for Payer: Cash Price |
$619.33
|
| Rate for Payer: Cash Price |
$15.32
|
| Rate for Payer: Cofinity Commercial |
$18.00
|
| Rate for Payer: Cofinity Commercial |
$727.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$619.33
|
| Rate for Payer: Healthscope Commercial |
$19.15
|
| Rate for Payer: Healthscope Commercial |
$774.16
|
| Rate for Payer: Healthscope Whirlpool |
$750.94
|
| Rate for Payer: Healthscope Whirlpool |
$18.58
|
| Rate for Payer: Mclaren Commercial |
$17.24
|
| Rate for Payer: Mclaren Commercial |
$696.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$658.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$541.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$681.26
|
|
|
PREDNISONE 10 MG TABLET
|
Facility
|
IP
|
$329.00
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6494
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$230.30 |
| Max. Negotiated Rate |
$329.00 |
| Rate for Payer: Aetna Commercial |
$296.10
|
| Rate for Payer: Aetna Commercial |
$3.46
|
| Rate for Payer: Aetna Commercial |
$241.11
|
| Rate for Payer: Aetna Commercial |
$346.86
|
| Rate for Payer: Aetna Commercial |
$42.08
|
| Rate for Payer: ASR ASR |
$373.84
|
| Rate for Payer: ASR ASR |
$259.86
|
| Rate for Payer: ASR ASR |
$3.73
|
| Rate for Payer: ASR ASR |
$45.36
|
| Rate for Payer: ASR ASR |
$319.13
|
| Rate for Payer: BCBS Trust/PPO |
$298.80
|
| Rate for Payer: BCBS Trust/PPO |
$207.70
|
| Rate for Payer: BCBS Trust/PPO |
$255.07
|
| Rate for Payer: BCBS Trust/PPO |
$36.25
|
| Rate for Payer: BCBS Trust/PPO |
$2.98
|
| Rate for Payer: BCN Commercial |
$2.98
|
| Rate for Payer: BCN Commercial |
$255.07
|
| Rate for Payer: BCN Commercial |
$207.70
|
| Rate for Payer: BCN Commercial |
$36.25
|
| Rate for Payer: BCN Commercial |
$298.80
|
| Rate for Payer: Cash Price |
$3.08
|
| Rate for Payer: Cash Price |
$308.32
|
| Rate for Payer: Cash Price |
$214.32
|
| Rate for Payer: Cash Price |
$263.20
|
| Rate for Payer: Cash Price |
$37.41
|
| Rate for Payer: Cofinity Commercial |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$309.26
|
| Rate for Payer: Cofinity Commercial |
$362.28
|
| Rate for Payer: Cofinity Commercial |
$251.83
|
| Rate for Payer: Cofinity Commercial |
$3.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.32
|
| Rate for Payer: Healthscope Commercial |
$46.76
|
| Rate for Payer: Healthscope Commercial |
$267.90
|
| Rate for Payer: Healthscope Commercial |
$329.00
|
| Rate for Payer: Healthscope Commercial |
$3.85
|
| Rate for Payer: Healthscope Commercial |
$385.40
|
| Rate for Payer: Healthscope Whirlpool |
$45.36
|
| Rate for Payer: Healthscope Whirlpool |
$373.84
|
| Rate for Payer: Healthscope Whirlpool |
$3.73
|
| Rate for Payer: Healthscope Whirlpool |
$319.13
|
| Rate for Payer: Healthscope Whirlpool |
$259.86
|
| Rate for Payer: Mclaren Commercial |
$3.46
|
| Rate for Payer: Mclaren Commercial |
$42.08
|
| Rate for Payer: Mclaren Commercial |
$346.86
|
| Rate for Payer: Mclaren Commercial |
$296.10
|
| Rate for Payer: Mclaren Commercial |
$241.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$227.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$279.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$327.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$235.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$289.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.15
|
|
|
PREDNISONE 1 MG TABLET
|
Facility
|
IP
|
$196.65
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6493
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$137.66 |
| Max. Negotiated Rate |
$196.65 |
| Rate for Payer: Aetna Commercial |
$176.98
|
| Rate for Payer: Aetna Commercial |
$406.08
|
| Rate for Payer: ASR ASR |
$190.75
|
| Rate for Payer: ASR ASR |
$437.66
|
| Rate for Payer: BCBS Trust/PPO |
$349.82
|
| Rate for Payer: BCBS Trust/PPO |
$152.46
|
| Rate for Payer: BCN Commercial |
$152.46
|
| Rate for Payer: BCN Commercial |
$349.82
|
| Rate for Payer: Cash Price |
$157.32
|
| Rate for Payer: Cash Price |
$360.96
|
| Rate for Payer: Cofinity Commercial |
$424.13
|
| Rate for Payer: Cofinity Commercial |
$184.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.32
|
| Rate for Payer: Healthscope Commercial |
$451.20
|
| Rate for Payer: Healthscope Commercial |
$196.65
|
| Rate for Payer: Healthscope Whirlpool |
$437.66
|
| Rate for Payer: Healthscope Whirlpool |
$190.75
|
| Rate for Payer: Mclaren Commercial |
$406.08
|
| Rate for Payer: Mclaren Commercial |
$176.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$383.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$167.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$173.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$397.06
|
|
|
PREDNISONE 20 MG TABLET
|
Facility
|
IP
|
$20.14
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6496
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.10 |
| Max. Negotiated Rate |
$20.14 |
| Rate for Payer: Aetna Commercial |
$18.13
|
| Rate for Payer: Aetna Commercial |
$279.18
|
| Rate for Payer: Aetna Commercial |
$264.38
|
| Rate for Payer: Aetna Commercial |
$2.79
|
| Rate for Payer: Aetna Commercial |
$408.20
|
| Rate for Payer: ASR ASR |
$3.01
|
| Rate for Payer: ASR ASR |
$300.89
|
| Rate for Payer: ASR ASR |
$19.54
|
| Rate for Payer: ASR ASR |
$284.94
|
| Rate for Payer: ASR ASR |
$439.94
|
| Rate for Payer: BCBS Trust/PPO |
$240.50
|
| Rate for Payer: BCBS Trust/PPO |
$351.64
|
| Rate for Payer: BCBS Trust/PPO |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$227.74
|
| Rate for Payer: BCBS Trust/PPO |
$2.40
|
| Rate for Payer: BCN Commercial |
$15.61
|
| Rate for Payer: BCN Commercial |
$240.50
|
| Rate for Payer: BCN Commercial |
$227.74
|
| Rate for Payer: BCN Commercial |
$2.40
|
| Rate for Payer: BCN Commercial |
$351.64
|
| Rate for Payer: Cash Price |
$362.84
|
| Rate for Payer: Cash Price |
$235.00
|
| Rate for Payer: Cash Price |
$16.11
|
| Rate for Payer: Cash Price |
$248.16
|
| Rate for Payer: Cash Price |
$2.48
|
| Rate for Payer: Cofinity Commercial |
$291.59
|
| Rate for Payer: Cofinity Commercial |
$18.93
|
| Rate for Payer: Cofinity Commercial |
$276.12
|
| Rate for Payer: Cofinity Commercial |
$426.34
|
| Rate for Payer: Cofinity Commercial |
$2.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$362.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.11
|
| Rate for Payer: Healthscope Commercial |
$20.14
|
| Rate for Payer: Healthscope Commercial |
$293.75
|
| Rate for Payer: Healthscope Commercial |
$3.10
|
| Rate for Payer: Healthscope Commercial |
$310.20
|
| Rate for Payer: Healthscope Commercial |
$453.55
|
| Rate for Payer: Healthscope Whirlpool |
$3.01
|
| Rate for Payer: Healthscope Whirlpool |
$300.89
|
| Rate for Payer: Healthscope Whirlpool |
$439.94
|
| Rate for Payer: Healthscope Whirlpool |
$19.54
|
| Rate for Payer: Healthscope Whirlpool |
$284.94
|
| Rate for Payer: Mclaren Commercial |
$264.38
|
| Rate for Payer: Mclaren Commercial |
$2.79
|
| Rate for Payer: Mclaren Commercial |
$279.18
|
| Rate for Payer: Mclaren Commercial |
$18.13
|
| Rate for Payer: Mclaren Commercial |
$408.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$263.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$385.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$317.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$399.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$272.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$258.50
|
|
|
PREDNISONE 50 MG TABLET
|
Facility
|
IP
|
$296.40
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6498
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$207.48 |
| Max. Negotiated Rate |
$296.40 |
| Rate for Payer: Aetna Commercial |
$266.76
|
| Rate for Payer: ASR ASR |
$287.51
|
| Rate for Payer: BCBS Trust/PPO |
$229.80
|
| Rate for Payer: BCN Commercial |
$229.80
|
| Rate for Payer: Cash Price |
$237.12
|
| Rate for Payer: Cofinity Commercial |
$278.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.12
|
| Rate for Payer: Healthscope Commercial |
$296.40
|
| Rate for Payer: Healthscope Whirlpool |
$287.51
|
| Rate for Payer: Mclaren Commercial |
$266.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$251.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$260.83
|
|
|
PREDNISONE 5 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$18.05
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6492
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.64 |
| Max. Negotiated Rate |
$18.05 |
| Rate for Payer: Aetna Commercial |
$16.24
|
| Rate for Payer: Aetna Commercial |
$20.30
|
| Rate for Payer: Aetna Commercial |
$290.30
|
| Rate for Payer: ASR ASR |
$312.88
|
| Rate for Payer: ASR ASR |
$21.88
|
| Rate for Payer: ASR ASR |
$17.51
|
| Rate for Payer: BCBS Trust/PPO |
$13.99
|
| Rate for Payer: BCBS Trust/PPO |
$250.08
|
| Rate for Payer: BCBS Trust/PPO |
$17.49
|
| Rate for Payer: BCN Commercial |
$250.08
|
| Rate for Payer: BCN Commercial |
$13.99
|
| Rate for Payer: BCN Commercial |
$17.49
|
| Rate for Payer: Cash Price |
$14.44
|
| Rate for Payer: Cash Price |
$258.05
|
| Rate for Payer: Cash Price |
$18.05
|
| Rate for Payer: Cofinity Commercial |
$21.21
|
| Rate for Payer: Cofinity Commercial |
$16.97
|
| Rate for Payer: Cofinity Commercial |
$303.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.05
|
| Rate for Payer: Healthscope Commercial |
$22.56
|
| Rate for Payer: Healthscope Commercial |
$322.56
|
| Rate for Payer: Healthscope Commercial |
$18.05
|
| Rate for Payer: Healthscope Whirlpool |
$21.88
|
| Rate for Payer: Healthscope Whirlpool |
$17.51
|
| Rate for Payer: Healthscope Whirlpool |
$312.88
|
| Rate for Payer: Mclaren Commercial |
$290.30
|
| Rate for Payer: Mclaren Commercial |
$16.24
|
| Rate for Payer: Mclaren Commercial |
$20.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$274.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$19.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$283.85
|
|
|
PREDNISONE 5 MG TABLET
|
Facility
|
IP
|
$366.60
|
|
|
Service Code
|
HCPCS J7512
|
| Hospital Charge Code |
6497
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$256.62 |
| Max. Negotiated Rate |
$366.60 |
| Rate for Payer: Aetna Commercial |
$329.94
|
| Rate for Payer: Aetna Commercial |
$39.13
|
| Rate for Payer: Aetna Commercial |
$270.72
|
| Rate for Payer: Aetna Commercial |
$3.30
|
| Rate for Payer: ASR ASR |
$3.56
|
| Rate for Payer: ASR ASR |
$355.60
|
| Rate for Payer: ASR ASR |
$42.18
|
| Rate for Payer: ASR ASR |
$291.78
|
| Rate for Payer: BCBS Trust/PPO |
$284.22
|
| Rate for Payer: BCBS Trust/PPO |
$233.21
|
| Rate for Payer: BCBS Trust/PPO |
$2.85
|
| Rate for Payer: BCBS Trust/PPO |
$33.71
|
| Rate for Payer: BCN Commercial |
$2.85
|
| Rate for Payer: BCN Commercial |
$284.22
|
| Rate for Payer: BCN Commercial |
$33.71
|
| Rate for Payer: BCN Commercial |
$233.21
|
| Rate for Payer: Cash Price |
$293.28
|
| Rate for Payer: Cash Price |
$240.64
|
| Rate for Payer: Cash Price |
$34.78
|
| Rate for Payer: Cash Price |
$2.93
|
| Rate for Payer: Cofinity Commercial |
$282.75
|
| Rate for Payer: Cofinity Commercial |
$344.60
|
| Rate for Payer: Cofinity Commercial |
$3.45
|
| Rate for Payer: Cofinity Commercial |
$40.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.64
|
| Rate for Payer: Healthscope Commercial |
$43.48
|
| Rate for Payer: Healthscope Commercial |
$366.60
|
| Rate for Payer: Healthscope Commercial |
$3.67
|
| Rate for Payer: Healthscope Commercial |
$300.80
|
| Rate for Payer: Healthscope Whirlpool |
$42.18
|
| Rate for Payer: Healthscope Whirlpool |
$291.78
|
| Rate for Payer: Healthscope Whirlpool |
$355.60
|
| Rate for Payer: Healthscope Whirlpool |
$3.56
|
| Rate for Payer: Mclaren Commercial |
$270.72
|
| Rate for Payer: Mclaren Commercial |
$329.94
|
| Rate for Payer: Mclaren Commercial |
$3.30
|
| Rate for Payer: Mclaren Commercial |
$39.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$311.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$255.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.23
|
|
|
PR EDUCATION&TRAINING SELF-MGMT NONPHYS 1 PT
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 98960
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$505.58 |
| Rate for Payer: Aetna Commercial |
$28.53
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS Trust/PPO |
$505.58
|
| Rate for Payer: BCN Commercial |
$33.79
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.07
|
| Rate for Payer: Priority Health Narrow Network |
$39.07
|
|
|
PR EDUCATION&TRAINING SELF-MGMT NONPHYS 2-4 PTS
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 98961
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$656.15 |
| Rate for Payer: Aetna Commercial |
$13.91
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS Trust/PPO |
$656.15
|
| Rate for Payer: BCN Commercial |
$14.19
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.86
|
| Rate for Payer: Priority Health Narrow Network |
$18.86
|
|
|
PR EDUCATION&TRAINING SELF-MGMT NONPHYS 5-8 PTS
|
Professional
|
Both
|
$17.00
|
|
|
Service Code
|
HCPCS 98962
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$888.07 |
| Rate for Payer: Aetna Commercial |
$10.35
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: BCBS Trust/PPO |
$888.07
|
| Rate for Payer: BCN Commercial |
$10.55
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.93
|
| Rate for Payer: Priority Health Narrow Network |
$13.93
|
|
|
PR EEG,ALL NIGHT RECORD
|
Professional
|
Both
|
$1,319.00
|
|
|
Service Code
|
HCPCS 95827
|
| Min. Negotiated Rate |
$527.60 |
| Max. Negotiated Rate |
$923.30 |
| Rate for Payer: BCBS Complete |
$527.60
|
| Rate for Payer: Cash Price |
$1,055.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$923.30
|
|
|
PR EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/O VIDEO
|
Professional
|
Both
|
$420.00
|
|
|
Service Code
|
HCPCS 95721
|
| Min. Negotiated Rate |
$129.93 |
| Max. Negotiated Rate |
$405.73 |
| Rate for Payer: Aetna Commercial |
$265.98
|
| Rate for Payer: Aetna Medicare |
$198.49
|
| Rate for Payer: BCBS Complete |
$136.43
|
| Rate for Payer: BCBS MAPPO |
$198.49
|
| Rate for Payer: BCBS Trust/PPO |
$405.73
|
| Rate for Payer: BCN Commercial |
$299.07
|
| Rate for Payer: BCN Medicare Advantage |
$198.49
|
| Rate for Payer: Cash Price |
$336.00
|
| Rate for Payer: Cash Price |
$336.00
|
| Rate for Payer: Cofinity Commercial |
$265.98
|
| Rate for Payer: Cofinity Commercial |
$285.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.49
|
| Rate for Payer: Healthscope Commercial |
$238.19
|
| Rate for Payer: Healthscope Whirlpool |
$238.19
|
| Rate for Payer: Meridian Medicaid |
$136.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$208.41
|
| Rate for Payer: PACE SWMI |
$198.49
|
| Rate for Payer: PHP Medicare Advantage |
$198.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.48
|
| Rate for Payer: Priority Health Medicare |
$198.49
|
| Rate for Payer: Priority Health Narrow Network |
$269.48
|
| Rate for Payer: UHC Medicare Advantage |
$204.44
|
|
|
PR EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/VEEG
|
Professional
|
Both
|
$510.00
|
|
|
Service Code
|
HCPCS 95722
|
| Min. Negotiated Rate |
$157.62 |
| Max. Negotiated Rate |
$364.06 |
| Rate for Payer: Aetna Commercial |
$324.16
|
| Rate for Payer: Aetna Medicare |
$241.91
|
| Rate for Payer: BCBS Complete |
$165.50
|
| Rate for Payer: BCBS MAPPO |
$241.91
|
| Rate for Payer: BCBS Trust/PPO |
$240.38
|
| Rate for Payer: BCN Commercial |
$364.06
|
| Rate for Payer: BCN Medicare Advantage |
$241.91
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$348.35
|
| Rate for Payer: Cofinity Commercial |
$324.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.91
|
| Rate for Payer: Healthscope Commercial |
$290.29
|
| Rate for Payer: Healthscope Whirlpool |
$290.29
|
| Rate for Payer: Meridian Medicaid |
$165.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$254.01
|
| Rate for Payer: PACE SWMI |
$241.91
|
| Rate for Payer: PHP Medicare Advantage |
$241.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$328.33
|
| Rate for Payer: Priority Health Medicare |
$241.91
|
| Rate for Payer: Priority Health Narrow Network |
$328.33
|
| Rate for Payer: UHC Medicare Advantage |
$249.17
|
|
|
PR EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/O VIDEO
|
Professional
|
Both
|
$521.00
|
|
|
Service Code
|
HCPCS 95723
|
| Min. Negotiated Rate |
$157.62 |
| Max. Negotiated Rate |
$365.53 |
| Rate for Payer: Aetna Commercial |
$325.46
|
| Rate for Payer: Aetna Medicare |
$242.88
|
| Rate for Payer: BCBS Complete |
$165.50
|
| Rate for Payer: BCBS MAPPO |
$242.88
|
| Rate for Payer: BCBS Trust/PPO |
$282.64
|
| Rate for Payer: BCN Commercial |
$365.53
|
| Rate for Payer: BCN Medicare Advantage |
$242.88
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cofinity Commercial |
$349.75
|
| Rate for Payer: Cofinity Commercial |
$325.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$242.88
|
| Rate for Payer: Healthscope Commercial |
$291.46
|
| Rate for Payer: Healthscope Whirlpool |
$291.46
|
| Rate for Payer: Meridian Medicaid |
$165.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$255.02
|
| Rate for Payer: PACE SWMI |
$242.88
|
| Rate for Payer: PHP Medicare Advantage |
$242.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$329.67
|
| Rate for Payer: Priority Health Medicare |
$242.88
|
| Rate for Payer: Priority Health Narrow Network |
$329.67
|
| Rate for Payer: UHC Medicare Advantage |
$250.17
|
|
|
PR EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/VEEG
|
Professional
|
Both
|
$651.00
|
|
|
Service Code
|
HCPCS 95724
|
| Min. Negotiated Rate |
$198.30 |
| Max. Negotiated Rate |
$460.34 |
| Rate for Payer: Aetna Commercial |
$410.60
|
| Rate for Payer: Aetna Medicare |
$306.42
|
| Rate for Payer: BCBS Complete |
$208.22
|
| Rate for Payer: BCBS MAPPO |
$306.42
|
| Rate for Payer: BCBS Trust/PPO |
$438.49
|
| Rate for Payer: BCN Commercial |
$460.34
|
| Rate for Payer: BCN Medicare Advantage |
$306.42
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Cash Price |
$520.80
|
| Rate for Payer: Cofinity Commercial |
$441.24
|
| Rate for Payer: Cofinity Commercial |
$410.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$306.42
|
| Rate for Payer: Healthscope Commercial |
$367.70
|
| Rate for Payer: Healthscope Whirlpool |
$367.70
|
| Rate for Payer: Meridian Medicaid |
$208.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$321.74
|
| Rate for Payer: PACE SWMI |
$306.42
|
| Rate for Payer: PHP Medicare Advantage |
$306.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$198.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$415.91
|
| Rate for Payer: Priority Health Medicare |
$306.42
|
| Rate for Payer: Priority Health Narrow Network |
$415.91
|
| Rate for Payer: UHC Medicare Advantage |
$315.61
|
|
|
PR EEG COMPLETE STD PHYS/QHP>84 HR W/O VID
|
Professional
|
Both
|
$595.00
|
|
|
Service Code
|
HCPCS 95725
|
| Min. Negotiated Rate |
$181.90 |
| Max. Negotiated Rate |
$476.00 |
| Rate for Payer: Aetna Commercial |
$371.56
|
| Rate for Payer: Aetna Medicare |
$277.28
|
| Rate for Payer: BCBS Complete |
$191.00
|
| Rate for Payer: BCBS MAPPO |
$277.28
|
| Rate for Payer: BCBS Trust/PPO |
$476.00
|
| Rate for Payer: BCN Commercial |
$418.30
|
| Rate for Payer: BCN Medicare Advantage |
$277.28
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cash Price |
$476.00
|
| Rate for Payer: Cofinity Commercial |
$399.28
|
| Rate for Payer: Cofinity Commercial |
$371.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$277.28
|
| Rate for Payer: Healthscope Commercial |
$332.74
|
| Rate for Payer: Healthscope Whirlpool |
$332.74
|
| Rate for Payer: Meridian Medicaid |
$191.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$291.14
|
| Rate for Payer: PACE SWMI |
$277.28
|
| Rate for Payer: PHP Medicare Advantage |
$277.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$181.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$416.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$376.38
|
| Rate for Payer: Priority Health Medicare |
$277.28
|
| Rate for Payer: Priority Health Narrow Network |
$376.38
|
| Rate for Payer: UHC Medicare Advantage |
$285.60
|
|
|
PR EEG COMPLETE STD PHYS/QHP>84 HR W/VEEG
|
Professional
|
Both
|
$823.00
|
|
|
Service Code
|
HCPCS 95726
|
| Min. Negotiated Rate |
$254.11 |
| Max. Negotiated Rate |
$585.43 |
| Rate for Payer: Aetna Commercial |
$521.46
|
| Rate for Payer: Aetna Medicare |
$389.15
|
| Rate for Payer: BCBS Complete |
$266.82
|
| Rate for Payer: BCBS MAPPO |
$389.15
|
| Rate for Payer: BCBS Trust/PPO |
$530.41
|
| Rate for Payer: BCN Commercial |
$585.43
|
| Rate for Payer: BCN Medicare Advantage |
$389.15
|
| Rate for Payer: Cash Price |
$658.40
|
| Rate for Payer: Cash Price |
$658.40
|
| Rate for Payer: Cofinity Commercial |
$521.46
|
| Rate for Payer: Cofinity Commercial |
$560.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.15
|
| Rate for Payer: Healthscope Commercial |
$466.98
|
| Rate for Payer: Healthscope Whirlpool |
$466.98
|
| Rate for Payer: Meridian Medicaid |
$266.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$408.61
|
| Rate for Payer: PACE SWMI |
$389.15
|
| Rate for Payer: PHP Medicare Advantage |
$389.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$528.19
|
| Rate for Payer: Priority Health Medicare |
$389.15
|
| Rate for Payer: Priority Health Narrow Network |
$528.19
|
| Rate for Payer: UHC Medicare Advantage |
$400.82
|
|
|
PR EEG EXTENDED MONITORING 61-119 MINUTES
|
Professional
|
Both
|
$851.00
|
|
|
Service Code
|
HCPCS 95813
|
| Min. Negotiated Rate |
$340.40 |
| Max. Negotiated Rate |
$692.07 |
| Rate for Payer: Aetna Commercial |
$537.74
|
| Rate for Payer: Aetna Medicare |
$401.30
|
| Rate for Payer: BCBS Complete |
$340.40
|
| Rate for Payer: BCBS MAPPO |
$401.30
|
| Rate for Payer: BCBS Trust/PPO |
$692.07
|
| Rate for Payer: BCN Commercial |
$626.48
|
| Rate for Payer: BCN Medicare Advantage |
$401.30
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cofinity Commercial |
$577.87
|
| Rate for Payer: Cofinity Commercial |
$537.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.30
|
| Rate for Payer: Healthscope Commercial |
$481.56
|
| Rate for Payer: Healthscope Whirlpool |
$481.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$421.36
|
| Rate for Payer: PACE SWMI |
$401.30
|
| Rate for Payer: PHP Medicare Advantage |
$401.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$595.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$575.80
|
| Rate for Payer: Priority Health Medicare |
$401.30
|
| Rate for Payer: Priority Health Narrow Network |
$575.80
|
| Rate for Payer: UHC Medicare Advantage |
$413.34
|
|
|
PR EEG MONITORING/COMPUTER, EA 24 HOURS, ATTENDED BY TECH/NURSE
|
Professional
|
Both
|
$2,832.00
|
|
|
Service Code
|
HCPCS 95956
|
| Min. Negotiated Rate |
$1,132.80 |
| Max. Negotiated Rate |
$1,982.40 |
| Rate for Payer: BCBS Complete |
$1,132.80
|
| Rate for Payer: Cash Price |
$2,265.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,982.40
|
|
|
PR EEG MONITORING/COMPUTER, EA 24 HOURS, UNATTENDED
|
Professional
|
Both
|
$732.00
|
|
|
Service Code
|
HCPCS 95953
|
| Min. Negotiated Rate |
$292.80 |
| Max. Negotiated Rate |
$512.40 |
| Rate for Payer: BCBS Complete |
$292.80
|
| Rate for Payer: Cash Price |
$585.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.40
|
|
|
PR EEG MONITORING/VIDEORECORD
|
Professional
|
Both
|
$1,525.00
|
|
|
Service Code
|
HCPCS 95951
|
| Min. Negotiated Rate |
$610.00 |
| Max. Negotiated Rate |
$1,067.50 |
| Rate for Payer: BCBS Complete |
$610.00
|
| Rate for Payer: BCBS Complete |
$1,216.40
|
| Rate for Payer: Cash Price |
$2,432.80
|
| Rate for Payer: Cash Price |
$1,220.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,067.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,128.70
|
|
|
PR EEG PHYS/QHP 2-12 HR WITHOUT VIDEO
|
Professional
|
Both
|
$205.00
|
|
|
Service Code
|
HCPCS 95717
|
| Min. Negotiated Rate |
$66.67 |
| Max. Negotiated Rate |
$729.05 |
| Rate for Payer: Aetna Commercial |
$131.84
|
| Rate for Payer: Aetna Medicare |
$98.39
|
| Rate for Payer: BCBS Complete |
$70.00
|
| Rate for Payer: BCBS MAPPO |
$98.39
|
| Rate for Payer: BCBS Trust/PPO |
$729.05
|
| Rate for Payer: BCN Commercial |
$146.60
|
| Rate for Payer: BCN Medicare Advantage |
$98.39
|
| Rate for Payer: Cash Price |
$164.00
|
| Rate for Payer: Cash Price |
$164.00
|
| Rate for Payer: Cofinity Commercial |
$141.68
|
| Rate for Payer: Cofinity Commercial |
$131.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.39
|
| Rate for Payer: Healthscope Commercial |
$118.07
|
| Rate for Payer: Healthscope Whirlpool |
$118.07
|
| Rate for Payer: Meridian Medicaid |
$70.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$103.31
|
| Rate for Payer: PACE SWMI |
$98.39
|
| Rate for Payer: PHP Medicare Advantage |
$98.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.39
|
| Rate for Payer: Priority Health Medicare |
$98.39
|
| Rate for Payer: Priority Health Narrow Network |
$133.39
|
| Rate for Payer: UHC Medicare Advantage |
$101.34
|
|
|
PR EEG PHYS/QHP 2-12 HR WITH VEEG
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 95718
|
| Min. Negotiated Rate |
$84.56 |
| Max. Negotiated Rate |
$379.32 |
| Rate for Payer: Aetna Commercial |
$172.86
|
| Rate for Payer: Aetna Medicare |
$129.00
|
| Rate for Payer: BCBS Complete |
$88.79
|
| Rate for Payer: BCBS MAPPO |
$129.00
|
| Rate for Payer: BCBS Trust/PPO |
$379.32
|
| Rate for Payer: BCN Commercial |
$194.01
|
| Rate for Payer: BCN Medicare Advantage |
$129.00
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cofinity Commercial |
$185.76
|
| Rate for Payer: Cofinity Commercial |
$172.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.00
|
| Rate for Payer: Healthscope Commercial |
$154.80
|
| Rate for Payer: Healthscope Whirlpool |
$154.80
|
| Rate for Payer: Meridian Medicaid |
$88.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$135.45
|
| Rate for Payer: PACE SWMI |
$129.00
|
| Rate for Payer: PHP Medicare Advantage |
$129.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.17
|
| Rate for Payer: Priority Health Medicare |
$129.00
|
| Rate for Payer: Priority Health Narrow Network |
$175.17
|
| Rate for Payer: UHC Medicare Advantage |
$132.87
|
|
