|
PR AAA REPR,1ST VESSEL,EXTENSION PROSTH
|
Professional
|
Both
|
$2,779.00
|
|
|
Service Code
|
HCPCS 34825
|
| Min. Negotiated Rate |
$1,111.60 |
| Max. Negotiated Rate |
$2,084.25 |
| Rate for Payer: BCBS Complete |
$1,111.60
|
| Rate for Payer: Cash Price |
$2,223.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,084.25
|
|
|
PR AAA REPR,ADD VESSEL,EXTENSION PROSTH
|
Professional
|
Both
|
$449.00
|
|
|
Service Code
|
HCPCS 34826
|
| Min. Negotiated Rate |
$179.60 |
| Max. Negotiated Rate |
$336.75 |
| Rate for Payer: BCBS Complete |
$179.60
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$336.75
|
|
|
PR ABATACEPT INJECTION
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS J0129
|
| Min. Negotiated Rate |
$31.50 |
| Max. Negotiated Rate |
$64.40 |
| Rate for Payer: Aetna Commercial |
$59.92
|
| Rate for Payer: Aetna Medicare |
$44.72
|
| Rate for Payer: BCBS MAPPO |
$44.72
|
| Rate for Payer: BCBS Trust/PPO |
$58.53
|
| Rate for Payer: BCN Commercial |
$57.21
|
| Rate for Payer: BCN Medicare Advantage |
$44.72
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$64.40
|
| Rate for Payer: Cofinity Commercial |
$59.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.72
|
| Rate for Payer: Healthscope Commercial |
$53.66
|
| Rate for Payer: Healthscope Whirlpool |
$53.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.19
|
| Rate for Payer: Nomi Health Commercial |
$53.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.50
|
| Rate for Payer: PACE SWMI |
$44.72
|
| Rate for Payer: PHP Medicare Advantage |
$44.72
|
| Rate for Payer: Priority Health Medicare |
$44.72
|
| Rate for Payer: Railroad Medicare Medicare |
$44.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.72
|
| Rate for Payer: UHC Exchange |
$44.77
|
| Rate for Payer: UHCCP DNSP |
$44.72
|
|
|
PR ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC
|
Professional
|
Both
|
$497.00
|
|
|
Service Code
|
HCPCS 38747
|
| Min. Negotiated Rate |
$152.72 |
| Max. Negotiated Rate |
$525.45 |
| Rate for Payer: Aetna Commercial |
$323.03
|
| Rate for Payer: Aetna Medicare |
$241.07
|
| Rate for Payer: BCBS Complete |
$160.36
|
| Rate for Payer: BCBS MAPPO |
$241.07
|
| Rate for Payer: BCN Commercial |
$394.90
|
| Rate for Payer: BCN Medicare Advantage |
$241.07
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cofinity Commercial |
$323.03
|
| Rate for Payer: Cofinity Commercial |
$347.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$241.07
|
| Rate for Payer: Healthscope Commercial |
$289.28
|
| Rate for Payer: Healthscope Whirlpool |
$289.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$253.12
|
| Rate for Payer: Meridian Medicaid |
$160.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$265.18
|
| Rate for Payer: Nomi Health Commercial |
$289.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$372.75
|
| Rate for Payer: PACE SWMI |
$241.07
|
| Rate for Payer: PHP Medicare Advantage |
$241.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$525.45
|
| Rate for Payer: Priority Health Medicare |
$241.07
|
| Rate for Payer: Priority Health Narrow Network |
$525.45
|
| Rate for Payer: Railroad Medicare Medicare |
$241.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$478.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$241.07
|
| Rate for Payer: UHC Exchange |
$478.99
|
| Rate for Payer: UHC Medicaid |
$152.72
|
| Rate for Payer: UHCCP DNSP |
$241.07
|
| Rate for Payer: UHCCP Medicaid |
$152.72
|
|
|
PR ABDOMINOPLASTY (2HRS)
|
Professional
|
Both
|
$3,605.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,442.00 |
| Max. Negotiated Rate |
$2,703.75 |
| Rate for Payer: BCBS Complete |
$1,442.00
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,703.75
|
|
|
PR ABDOMINOPLASTY (3HRS)
|
Professional
|
Both
|
$5,408.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2,163.20 |
| Max. Negotiated Rate |
$4,056.00 |
| Rate for Payer: BCBS Complete |
$2,163.20
|
| Rate for Payer: Cash Price |
$4,326.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,056.00
|
|
|
PR ABDOMINOPLASTY W/ BREAST AUGMENT
|
Professional
|
Both
|
$7,669.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$3,067.60 |
| Max. Negotiated Rate |
$5,751.75 |
| Rate for Payer: BCBS Complete |
$3,067.60
|
| Rate for Payer: Cash Price |
$6,135.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,751.75
|
|
|
PR ABDOMINO-VAG VESICAL NCK SSP W/WO NDSC CTRL
|
Professional
|
Both
|
$2,707.00
|
|
|
Service Code
|
HCPCS 51845
|
| Min. Negotiated Rate |
$338.24 |
| Max. Negotiated Rate |
$2,030.25 |
| Rate for Payer: Aetna Commercial |
$699.83
|
| Rate for Payer: Aetna Medicare |
$522.26
|
| Rate for Payer: BCBS Complete |
$355.15
|
| Rate for Payer: BCBS MAPPO |
$522.26
|
| Rate for Payer: BCN Commercial |
$875.45
|
| Rate for Payer: BCN Medicare Advantage |
$522.26
|
| Rate for Payer: Cash Price |
$2,165.60
|
| Rate for Payer: Cash Price |
$2,165.60
|
| Rate for Payer: Cofinity Commercial |
$752.05
|
| Rate for Payer: Cofinity Commercial |
$699.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$522.26
|
| Rate for Payer: Healthscope Commercial |
$626.71
|
| Rate for Payer: Healthscope Whirlpool |
$626.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$548.37
|
| Rate for Payer: Meridian Medicaid |
$355.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$574.49
|
| Rate for Payer: Nomi Health Commercial |
$626.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,030.25
|
| Rate for Payer: PACE SWMI |
$522.26
|
| Rate for Payer: PHP Medicare Advantage |
$522.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$338.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$953.65
|
| Rate for Payer: Priority Health Medicare |
$522.26
|
| Rate for Payer: Priority Health Narrow Network |
$953.65
|
| Rate for Payer: Railroad Medicare Medicare |
$522.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,025.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$522.26
|
| Rate for Payer: UHC Exchange |
$1,025.59
|
| Rate for Payer: UHC Medicaid |
$338.24
|
| Rate for Payer: UHCCP DNSP |
$522.26
|
| Rate for Payer: UHCCP Medicaid |
$338.24
|
|
|
PR ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE
|
Professional
|
Both
|
$489.00
|
|
|
Service Code
|
HCPCS 49083
|
| Min. Negotiated Rate |
$59.21 |
| Max. Negotiated Rate |
$366.75 |
| Rate for Payer: Aetna Commercial |
$123.23
|
| Rate for Payer: Aetna Medicare |
$91.96
|
| Rate for Payer: BCBS Complete |
$62.17
|
| Rate for Payer: BCBS MAPPO |
$91.96
|
| Rate for Payer: BCN Commercial |
$156.86
|
| Rate for Payer: BCN Medicare Advantage |
$91.96
|
| Rate for Payer: Cash Price |
$391.20
|
| Rate for Payer: Cash Price |
$391.20
|
| Rate for Payer: Cofinity Commercial |
$132.42
|
| Rate for Payer: Cofinity Commercial |
$123.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.96
|
| Rate for Payer: Healthscope Commercial |
$110.35
|
| Rate for Payer: Healthscope Whirlpool |
$110.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.56
|
| Rate for Payer: Meridian Medicaid |
$62.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$101.16
|
| Rate for Payer: Nomi Health Commercial |
$110.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$366.75
|
| Rate for Payer: PACE SWMI |
$91.96
|
| Rate for Payer: PHP Medicare Advantage |
$91.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$191.13
|
| Rate for Payer: Priority Health Medicare |
$91.96
|
| Rate for Payer: Priority Health Narrow Network |
$191.13
|
| Rate for Payer: Railroad Medicare Medicare |
$91.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$190.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.96
|
| Rate for Payer: UHC Exchange |
$190.32
|
| Rate for Payer: UHC Medicaid |
$59.21
|
| Rate for Payer: UHCCP DNSP |
$91.96
|
| Rate for Payer: UHCCP Medicaid |
$59.21
|
|
|
PR ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE
|
Professional
|
Both
|
$268.00
|
|
|
Service Code
|
HCPCS 49082
|
| Min. Negotiated Rate |
$45.37 |
| Max. Negotiated Rate |
$201.00 |
| Rate for Payer: Aetna Commercial |
$93.68
|
| Rate for Payer: Aetna Medicare |
$69.91
|
| Rate for Payer: BCBS Complete |
$47.64
|
| Rate for Payer: BCBS MAPPO |
$69.91
|
| Rate for Payer: BCN Commercial |
$108.56
|
| Rate for Payer: BCN Medicare Advantage |
$69.91
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Cofinity Commercial |
$93.68
|
| Rate for Payer: Cofinity Commercial |
$100.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.91
|
| Rate for Payer: Healthscope Commercial |
$83.89
|
| Rate for Payer: Healthscope Whirlpool |
$83.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.41
|
| Rate for Payer: Meridian Medicaid |
$47.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.90
|
| Rate for Payer: Nomi Health Commercial |
$83.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.00
|
| Rate for Payer: PACE SWMI |
$69.91
|
| Rate for Payer: PHP Medicare Advantage |
$69.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$132.28
|
| Rate for Payer: Priority Health Medicare |
$69.91
|
| Rate for Payer: Priority Health Narrow Network |
$132.28
|
| Rate for Payer: Railroad Medicare Medicare |
$69.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$130.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$69.91
|
| Rate for Payer: UHC Exchange |
$130.53
|
| Rate for Payer: UHC Medicaid |
$45.37
|
| Rate for Payer: UHCCP DNSP |
$69.91
|
| Rate for Payer: UHCCP Medicaid |
$45.37
|
|
|
PR ABLATE L/R ATRIAL FIBRIL W/ISOLATED PULM VEIN
|
Professional
|
Both
|
$902.00
|
|
|
Service Code
|
HCPCS 93657
|
| Min. Negotiated Rate |
$166.35 |
| Max. Negotiated Rate |
$760.22 |
| Rate for Payer: Aetna Commercial |
$352.29
|
| Rate for Payer: Aetna Medicare |
$262.90
|
| Rate for Payer: BCBS Complete |
$174.67
|
| Rate for Payer: BCBS MAPPO |
$262.90
|
| Rate for Payer: BCN Commercial |
$447.69
|
| Rate for Payer: BCN Medicare Advantage |
$262.90
|
| Rate for Payer: Cash Price |
$721.60
|
| Rate for Payer: Cash Price |
$721.60
|
| Rate for Payer: Cofinity Commercial |
$378.58
|
| Rate for Payer: Cofinity Commercial |
$352.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$262.90
|
| Rate for Payer: Healthscope Commercial |
$315.48
|
| Rate for Payer: Healthscope Whirlpool |
$315.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.05
|
| Rate for Payer: Meridian Medicaid |
$174.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$289.19
|
| Rate for Payer: Nomi Health Commercial |
$315.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$676.50
|
| Rate for Payer: PACE SWMI |
$262.90
|
| Rate for Payer: PHP Medicare Advantage |
$262.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$166.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$425.51
|
| Rate for Payer: Priority Health Medicare |
$262.90
|
| Rate for Payer: Priority Health Narrow Network |
$425.51
|
| Rate for Payer: Railroad Medicare Medicare |
$262.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$760.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$262.90
|
| Rate for Payer: UHC Exchange |
$760.22
|
| Rate for Payer: UHC Medicaid |
$166.35
|
| Rate for Payer: UHCCP DNSP |
$262.90
|
| Rate for Payer: UHCCP Medicaid |
$166.35
|
|
|
PR ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE
|
Professional
|
Both
|
$7,486.00
|
|
|
Service Code
|
HCPCS 20982
|
| Min. Negotiated Rate |
$205.12 |
| Max. Negotiated Rate |
$5,614.50 |
| Rate for Payer: Aetna Commercial |
$430.60
|
| Rate for Payer: Aetna Medicare |
$321.34
|
| Rate for Payer: BCBS Complete |
$215.38
|
| Rate for Payer: BCBS MAPPO |
$321.34
|
| Rate for Payer: BCN Commercial |
$543.80
|
| Rate for Payer: BCN Medicare Advantage |
$321.34
|
| Rate for Payer: Cash Price |
$5,988.80
|
| Rate for Payer: Cash Price |
$5,988.80
|
| Rate for Payer: Cofinity Commercial |
$462.73
|
| Rate for Payer: Cofinity Commercial |
$430.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$321.34
|
| Rate for Payer: Healthscope Commercial |
$385.61
|
| Rate for Payer: Healthscope Whirlpool |
$385.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$337.41
|
| Rate for Payer: Meridian Medicaid |
$215.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$353.47
|
| Rate for Payer: Nomi Health Commercial |
$385.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,614.50
|
| Rate for Payer: PACE SWMI |
$321.34
|
| Rate for Payer: PHP Medicare Advantage |
$321.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$581.30
|
| Rate for Payer: Priority Health Medicare |
$321.34
|
| Rate for Payer: Priority Health Narrow Network |
$581.30
|
| Rate for Payer: Railroad Medicare Medicare |
$321.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$648.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$321.34
|
| Rate for Payer: UHC Exchange |
$648.55
|
| Rate for Payer: UHC Medicaid |
$205.12
|
| Rate for Payer: UHCCP DNSP |
$321.34
|
| Rate for Payer: UHCCP Medicaid |
$205.12
|
|
|
PR ABLATION & RCNSTJ ATRIA EXTNSV W/BYPASS
|
Professional
|
Both
|
$3,879.00
|
|
|
Service Code
|
HCPCS 33256
|
| Min. Negotiated Rate |
$1,165.11 |
| Max. Negotiated Rate |
$3,449.69 |
| Rate for Payer: Aetna Commercial |
$2,446.52
|
| Rate for Payer: Aetna Medicare |
$1,825.76
|
| Rate for Payer: BCBS Complete |
$1,223.37
|
| Rate for Payer: BCBS MAPPO |
$1,825.76
|
| Rate for Payer: BCN Commercial |
$2,828.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,825.76
|
| Rate for Payer: Cash Price |
$3,103.20
|
| Rate for Payer: Cash Price |
$3,103.20
|
| Rate for Payer: Cofinity Commercial |
$2,629.09
|
| Rate for Payer: Cofinity Commercial |
$2,446.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,825.76
|
| Rate for Payer: Healthscope Commercial |
$2,190.91
|
| Rate for Payer: Healthscope Whirlpool |
$2,190.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,917.05
|
| Rate for Payer: Meridian Medicaid |
$1,223.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,008.34
|
| Rate for Payer: Nomi Health Commercial |
$2,190.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,909.25
|
| Rate for Payer: PACE SWMI |
$1,825.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,825.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,165.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,041.73
|
| Rate for Payer: Priority Health Medicare |
$1,825.76
|
| Rate for Payer: Priority Health Narrow Network |
$3,041.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,825.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,449.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,825.76
|
| Rate for Payer: UHC Exchange |
$3,449.69
|
| Rate for Payer: UHC Medicaid |
$1,165.11
|
| Rate for Payer: UHCCP DNSP |
$1,825.76
|
| Rate for Payer: UHCCP Medicaid |
$1,165.11
|
|
|
PR ABLATION & RECONSTRUCTION ATRIA LIMITED
|
Professional
|
Both
|
$3,460.00
|
|
|
Service Code
|
HCPCS 33254
|
| Min. Negotiated Rate |
$824.74 |
| Max. Negotiated Rate |
$2,595.00 |
| Rate for Payer: Aetna Commercial |
$1,727.17
|
| Rate for Payer: Aetna Medicare |
$1,288.93
|
| Rate for Payer: BCBS Complete |
$865.98
|
| Rate for Payer: BCBS MAPPO |
$1,288.93
|
| Rate for Payer: BCN Commercial |
$2,006.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,288.93
|
| Rate for Payer: Cash Price |
$2,768.00
|
| Rate for Payer: Cash Price |
$2,768.00
|
| Rate for Payer: Cofinity Commercial |
$1,856.06
|
| Rate for Payer: Cofinity Commercial |
$1,727.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,288.93
|
| Rate for Payer: Healthscope Commercial |
$1,546.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,546.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,353.38
|
| Rate for Payer: Meridian Medicaid |
$865.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,417.82
|
| Rate for Payer: Nomi Health Commercial |
$1,546.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,595.00
|
| Rate for Payer: PACE SWMI |
$1,288.93
|
| Rate for Payer: PHP Medicare Advantage |
$1,288.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$824.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,157.59
|
| Rate for Payer: Priority Health Medicare |
$1,288.93
|
| Rate for Payer: Priority Health Narrow Network |
$2,157.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,288.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,400.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,288.93
|
| Rate for Payer: UHC Exchange |
$2,400.71
|
| Rate for Payer: UHC Medicaid |
$824.74
|
| Rate for Payer: UHCCP DNSP |
$1,288.93
|
| Rate for Payer: UHCCP Medicaid |
$824.74
|
|
|
PR ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL
|
Professional
|
Both
|
$574.00
|
|
|
Service Code
|
HCPCS 30802
|
| Min. Negotiated Rate |
$116.94 |
| Max. Negotiated Rate |
$430.50 |
| Rate for Payer: Aetna Commercial |
$235.05
|
| Rate for Payer: Aetna Medicare |
$175.41
|
| Rate for Payer: BCBS Complete |
$122.79
|
| Rate for Payer: BCBS MAPPO |
$175.41
|
| Rate for Payer: BCN Commercial |
$300.78
|
| Rate for Payer: BCN Medicare Advantage |
$175.41
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cofinity Commercial |
$252.59
|
| Rate for Payer: Cofinity Commercial |
$235.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.41
|
| Rate for Payer: Healthscope Commercial |
$210.49
|
| Rate for Payer: Healthscope Whirlpool |
$210.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.18
|
| Rate for Payer: Meridian Medicaid |
$122.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.95
|
| Rate for Payer: Nomi Health Commercial |
$210.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$430.50
|
| Rate for Payer: PACE SWMI |
$175.41
|
| Rate for Payer: PHP Medicare Advantage |
$175.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$283.24
|
| Rate for Payer: Priority Health Medicare |
$175.41
|
| Rate for Payer: Priority Health Narrow Network |
$283.24
|
| Rate for Payer: Railroad Medicare Medicare |
$175.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$333.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$175.41
|
| Rate for Payer: UHC Exchange |
$333.19
|
| Rate for Payer: UHC Medicaid |
$116.94
|
| Rate for Payer: UHCCP DNSP |
$175.41
|
| Rate for Payer: UHCCP Medicaid |
$116.94
|
|
|
PR ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC
|
Professional
|
Both
|
$383.00
|
|
|
Service Code
|
HCPCS 30801
|
| Min. Negotiated Rate |
$89.46 |
| Max. Negotiated Rate |
$287.25 |
| Rate for Payer: Aetna Commercial |
$177.50
|
| Rate for Payer: Aetna Medicare |
$132.46
|
| Rate for Payer: BCBS Complete |
$93.93
|
| Rate for Payer: BCBS MAPPO |
$132.46
|
| Rate for Payer: BCN Commercial |
$224.59
|
| Rate for Payer: BCN Medicare Advantage |
$132.46
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cash Price |
$306.40
|
| Rate for Payer: Cofinity Commercial |
$190.74
|
| Rate for Payer: Cofinity Commercial |
$177.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.46
|
| Rate for Payer: Healthscope Commercial |
$158.95
|
| Rate for Payer: Healthscope Whirlpool |
$158.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.08
|
| Rate for Payer: Meridian Medicaid |
$93.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.71
|
| Rate for Payer: Nomi Health Commercial |
$158.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$287.25
|
| Rate for Payer: PACE SWMI |
$132.46
|
| Rate for Payer: PHP Medicare Advantage |
$132.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$211.49
|
| Rate for Payer: Priority Health Medicare |
$132.46
|
| Rate for Payer: Priority Health Narrow Network |
$211.49
|
| Rate for Payer: Railroad Medicare Medicare |
$132.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.46
|
| Rate for Payer: UHC Exchange |
$242.45
|
| Rate for Payer: UHC Medicaid |
$89.46
|
| Rate for Payer: UHCCP DNSP |
$132.46
|
| Rate for Payer: UHCCP Medicaid |
$89.46
|
|
|
PR ABRASION 1 LESION
|
Professional
|
Both
|
$455.00
|
|
|
Service Code
|
HCPCS 15786
|
| Min. Negotiated Rate |
$75.83 |
| Max. Negotiated Rate |
$341.25 |
| Rate for Payer: Aetna Commercial |
$155.31
|
| Rate for Payer: Aetna Medicare |
$115.90
|
| Rate for Payer: BCBS Complete |
$79.62
|
| Rate for Payer: BCBS MAPPO |
$115.90
|
| Rate for Payer: BCN Commercial |
$203.18
|
| Rate for Payer: BCN Medicare Advantage |
$115.90
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Cofinity Commercial |
$166.90
|
| Rate for Payer: Cofinity Commercial |
$155.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.90
|
| Rate for Payer: Healthscope Commercial |
$139.08
|
| Rate for Payer: Healthscope Whirlpool |
$139.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.69
|
| Rate for Payer: Meridian Medicaid |
$79.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$127.49
|
| Rate for Payer: Nomi Health Commercial |
$139.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$341.25
|
| Rate for Payer: PACE SWMI |
$115.90
|
| Rate for Payer: PHP Medicare Advantage |
$115.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$185.95
|
| Rate for Payer: Priority Health Medicare |
$115.90
|
| Rate for Payer: Priority Health Narrow Network |
$185.95
|
| Rate for Payer: Railroad Medicare Medicare |
$115.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$233.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$115.90
|
| Rate for Payer: UHC Exchange |
$233.42
|
| Rate for Payer: UHC Medicaid |
$75.83
|
| Rate for Payer: UHCCP DNSP |
$115.90
|
| Rate for Payer: UHCCP Medicaid |
$75.83
|
|
|
PR ACETABULOPLASTY RESECTION FEMORAL HEAD
|
Professional
|
Both
|
$2,035.00
|
|
|
Service Code
|
HCPCS 27122
|
| Min. Negotiated Rate |
$644.54 |
| Max. Negotiated Rate |
$1,930.88 |
| Rate for Payer: Aetna Commercial |
$1,329.82
|
| Rate for Payer: Aetna Medicare |
$992.40
|
| Rate for Payer: BCBS Complete |
$676.77
|
| Rate for Payer: BCBS MAPPO |
$992.40
|
| Rate for Payer: BCN Commercial |
$1,670.23
|
| Rate for Payer: BCN Medicare Advantage |
$992.40
|
| Rate for Payer: Cash Price |
$1,628.00
|
| Rate for Payer: Cash Price |
$1,628.00
|
| Rate for Payer: Cofinity Commercial |
$1,429.06
|
| Rate for Payer: Cofinity Commercial |
$1,329.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$992.40
|
| Rate for Payer: Healthscope Commercial |
$1,190.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,190.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,042.02
|
| Rate for Payer: Meridian Medicaid |
$676.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,091.64
|
| Rate for Payer: Nomi Health Commercial |
$1,190.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,526.25
|
| Rate for Payer: PACE SWMI |
$992.40
|
| Rate for Payer: PHP Medicare Advantage |
$992.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$644.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,785.42
|
| Rate for Payer: Priority Health Medicare |
$992.40
|
| Rate for Payer: Priority Health Narrow Network |
$1,785.42
|
| Rate for Payer: Railroad Medicare Medicare |
$992.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,930.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$992.40
|
| Rate for Payer: UHC Exchange |
$1,930.88
|
| Rate for Payer: UHC Medicaid |
$644.54
|
| Rate for Payer: UHCCP DNSP |
$992.40
|
| Rate for Payer: UHCCP Medicaid |
$644.54
|
|
|
PR ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS 92570
|
| Min. Negotiated Rate |
$15.12 |
| Max. Negotiated Rate |
$48.06 |
| Rate for Payer: Aetna Commercial |
$31.25
|
| Rate for Payer: Aetna Medicare |
$23.32
|
| Rate for Payer: BCBS Complete |
$15.88
|
| Rate for Payer: BCBS MAPPO |
$23.32
|
| Rate for Payer: BCN Commercial |
$42.82
|
| Rate for Payer: BCN Medicare Advantage |
$23.32
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$33.58
|
| Rate for Payer: Cofinity Commercial |
$31.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.32
|
| Rate for Payer: Healthscope Commercial |
$27.98
|
| Rate for Payer: Healthscope Whirlpool |
$27.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.49
|
| Rate for Payer: Meridian Medicaid |
$15.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.65
|
| Rate for Payer: Nomi Health Commercial |
$27.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.00
|
| Rate for Payer: PACE SWMI |
$23.32
|
| Rate for Payer: PHP Medicare Advantage |
$23.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$39.50
|
| Rate for Payer: Priority Health Medicare |
$23.32
|
| Rate for Payer: Priority Health Narrow Network |
$39.50
|
| Rate for Payer: Railroad Medicare Medicare |
$23.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.32
|
| Rate for Payer: UHC Exchange |
$48.06
|
| Rate for Payer: UHC Medicaid |
$15.12
|
| Rate for Payer: UHCCP DNSP |
$23.32
|
| Rate for Payer: UHCCP Medicaid |
$15.12
|
|
|
PR ACROMIOPLASTY/ACROMIONECTOMY PRTL +-LIGAMENT RLS
|
Professional
|
Both
|
$1,177.00
|
|
|
Service Code
|
HCPCS 23130
|
| Min. Negotiated Rate |
$376.80 |
| Max. Negotiated Rate |
$1,065.35 |
| Rate for Payer: Aetna Commercial |
$767.75
|
| Rate for Payer: Aetna Medicare |
$572.95
|
| Rate for Payer: BCBS Complete |
$395.64
|
| Rate for Payer: BCBS MAPPO |
$572.95
|
| Rate for Payer: BCN Commercial |
$949.16
|
| Rate for Payer: BCN Medicare Advantage |
$572.95
|
| Rate for Payer: Cash Price |
$941.60
|
| Rate for Payer: Cash Price |
$941.60
|
| Rate for Payer: Cofinity Commercial |
$825.05
|
| Rate for Payer: Cofinity Commercial |
$767.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$572.95
|
| Rate for Payer: Healthscope Commercial |
$687.54
|
| Rate for Payer: Healthscope Whirlpool |
$687.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$601.60
|
| Rate for Payer: Meridian Medicaid |
$395.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$630.25
|
| Rate for Payer: Nomi Health Commercial |
$687.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$882.75
|
| Rate for Payer: PACE SWMI |
$572.95
|
| Rate for Payer: PHP Medicare Advantage |
$572.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$376.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,014.61
|
| Rate for Payer: Priority Health Medicare |
$572.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,014.61
|
| Rate for Payer: Railroad Medicare Medicare |
$572.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,065.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$572.95
|
| Rate for Payer: UHC Exchange |
$1,065.35
|
| Rate for Payer: UHC Medicaid |
$376.80
|
| Rate for Payer: UHCCP DNSP |
$572.95
|
| Rate for Payer: UHCCP Medicaid |
$376.80
|
|
|
PR ACTIGRAPHY TESTING RECORDING ANALYSIS I&R
|
Professional
|
Both
|
$622.00
|
|
|
Service Code
|
HCPCS 95803
|
| Min. Negotiated Rate |
$126.42 |
| Max. Negotiated Rate |
$466.50 |
| Rate for Payer: Aetna Commercial |
$169.40
|
| Rate for Payer: Aetna Commercial |
$169.40
|
| Rate for Payer: Aetna Medicare |
$126.42
|
| Rate for Payer: Aetna Medicare |
$126.42
|
| Rate for Payer: BCBS MAPPO |
$126.42
|
| Rate for Payer: BCBS MAPPO |
$126.42
|
| Rate for Payer: BCN Commercial |
$194.71
|
| Rate for Payer: BCN Commercial |
$194.71
|
| Rate for Payer: BCN Medicare Advantage |
$126.42
|
| Rate for Payer: BCN Medicare Advantage |
$126.42
|
| Rate for Payer: Cash Price |
$497.60
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$497.60
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$169.40
|
| Rate for Payer: Cofinity Commercial |
$182.04
|
| Rate for Payer: Cofinity Commercial |
$169.40
|
| Rate for Payer: Cofinity Commercial |
$182.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.42
|
| Rate for Payer: Healthscope Commercial |
$151.70
|
| Rate for Payer: Healthscope Commercial |
$151.70
|
| Rate for Payer: Healthscope Whirlpool |
$151.70
|
| Rate for Payer: Healthscope Whirlpool |
$151.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.06
|
| Rate for Payer: Nomi Health Commercial |
$151.70
|
| Rate for Payer: Nomi Health Commercial |
$151.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$466.50
|
| Rate for Payer: PACE SWMI |
$126.42
|
| Rate for Payer: PACE SWMI |
$126.42
|
| Rate for Payer: PHP Medicare Advantage |
$126.42
|
| Rate for Payer: PHP Medicare Advantage |
$126.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$179.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$179.56
|
| Rate for Payer: Priority Health Medicare |
$126.42
|
| Rate for Payer: Priority Health Medicare |
$126.42
|
| Rate for Payer: Priority Health Narrow Network |
$179.56
|
| Rate for Payer: Priority Health Narrow Network |
$179.56
|
| Rate for Payer: Railroad Medicare Medicare |
$126.42
|
| Rate for Payer: Railroad Medicare Medicare |
$126.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$228.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$126.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$126.42
|
| Rate for Payer: UHC Exchange |
$228.99
|
| Rate for Payer: UHC Exchange |
$228.99
|
| Rate for Payer: UHCCP DNSP |
$126.42
|
| Rate for Payer: UHCCP DNSP |
$126.42
|
|
|
PR ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 97155
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$54.88 |
| Rate for Payer: Aetna Commercial |
$20.80
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: BCN Commercial |
$25.38
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$45.93
|
| Rate for Payer: Priority Health Narrow Network |
$45.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.88
|
| Rate for Payer: UHC Exchange |
$54.88
|
|
|
PR ADDITIONAL KIT 2-4 CC, INJECTION, PLATELET RICH PLASMA
|
Professional
|
Both
|
$210.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: BCBS Complete |
$84.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.50
|
|
|
PR ADDITIONAL KIT 4-10 CC, INJECTION, PLATELET RICH PLASMA
|
Professional
|
Both
|
$315.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: BCBS Complete |
$126.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.25
|
|
|
PR ADENOIDECTOMY PRIMARY <AGE 12
|
Professional
|
Both
|
$390.00
|
|
|
Service Code
|
HCPCS 42830
|
| Min. Negotiated Rate |
$124.61 |
| Max. Negotiated Rate |
$396.21 |
| Rate for Payer: Aetna Commercial |
$252.76
|
| Rate for Payer: Aetna Medicare |
$188.63
|
| Rate for Payer: BCBS Complete |
$130.84
|
| Rate for Payer: BCBS MAPPO |
$188.63
|
| Rate for Payer: BCN Commercial |
$325.18
|
| Rate for Payer: BCN Medicare Advantage |
$188.63
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cash Price |
$312.00
|
| Rate for Payer: Cofinity Commercial |
$252.76
|
| Rate for Payer: Cofinity Commercial |
$271.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.63
|
| Rate for Payer: Healthscope Commercial |
$226.36
|
| Rate for Payer: Healthscope Whirlpool |
$226.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.06
|
| Rate for Payer: Meridian Medicaid |
$130.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$207.49
|
| Rate for Payer: Nomi Health Commercial |
$226.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$292.50
|
| Rate for Payer: PACE SWMI |
$188.63
|
| Rate for Payer: PHP Medicare Advantage |
$188.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$396.21
|
| Rate for Payer: Priority Health Medicare |
$188.63
|
| Rate for Payer: Priority Health Narrow Network |
$396.21
|
| Rate for Payer: Railroad Medicare Medicare |
$188.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$357.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$188.63
|
| Rate for Payer: UHC Exchange |
$357.97
|
| Rate for Payer: UHC Medicaid |
$124.61
|
| Rate for Payer: UHCCP DNSP |
$188.63
|
| Rate for Payer: UHCCP Medicaid |
$124.61
|
|
