|
PR ADMIN PNEUMOCOCCAL VACCINE
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS G0009
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$47.76 |
| Rate for Payer: Aetna Commercial |
$10.00
|
| Rate for Payer: BCN Commercial |
$22.11
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$47.76
|
| Rate for Payer: Priority Health Narrow Network |
$47.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.76
|
| Rate for Payer: UHC Exchange |
$13.76
|
|
|
PR ADMN RSV MONOC ANTB SEASONAL DOS IM CNSL PHY/QHP
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
HCPCS 96380
|
| Min. Negotiated Rate |
$23.22 |
| Max. Negotiated Rate |
$66.00 |
| Rate for Payer: Aetna Commercial |
$38.06
|
| Rate for Payer: Aetna Medicare |
$28.40
|
| Rate for Payer: BCBS MAPPO |
$28.40
|
| Rate for Payer: BCN Commercial |
$27.07
|
| Rate for Payer: BCN Medicare Advantage |
$28.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$40.90
|
| Rate for Payer: Cofinity Commercial |
$38.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.40
|
| Rate for Payer: Healthscope Commercial |
$34.08
|
| Rate for Payer: Healthscope Whirlpool |
$34.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.24
|
| Rate for Payer: Nomi Health Commercial |
$34.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.00
|
| Rate for Payer: PACE SWMI |
$28.40
|
| Rate for Payer: PHP Medicare Advantage |
$28.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$31.69
|
| Rate for Payer: Priority Health Medicare |
$28.40
|
| Rate for Payer: Priority Health Narrow Network |
$31.69
|
| Rate for Payer: Railroad Medicare Medicare |
$28.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.40
|
| Rate for Payer: UHC Exchange |
$23.22
|
| Rate for Payer: UHCCP DNSP |
$28.40
|
|
|
PR ADMN RSV MONOCLONAL ANTB SEASONAL DOSE IM NJX
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
HCPCS 96381
|
| Min. Negotiated Rate |
$20.03 |
| Max. Negotiated Rate |
$66.00 |
| Rate for Payer: Aetna Commercial |
$30.59
|
| Rate for Payer: Aetna Medicare |
$22.83
|
| Rate for Payer: BCBS MAPPO |
$22.83
|
| Rate for Payer: BCN Commercial |
$27.07
|
| Rate for Payer: BCN Medicare Advantage |
$22.83
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$30.59
|
| Rate for Payer: Cofinity Commercial |
$32.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.83
|
| Rate for Payer: Healthscope Commercial |
$27.40
|
| Rate for Payer: Healthscope Whirlpool |
$27.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.11
|
| Rate for Payer: Nomi Health Commercial |
$27.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.00
|
| Rate for Payer: PACE SWMI |
$22.83
|
| Rate for Payer: PHP Medicare Advantage |
$22.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$27.09
|
| Rate for Payer: Priority Health Medicare |
$22.83
|
| Rate for Payer: Priority Health Narrow Network |
$27.09
|
| Rate for Payer: Railroad Medicare Medicare |
$22.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$20.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.83
|
| Rate for Payer: UHC Exchange |
$20.03
|
| Rate for Payer: UHCCP DNSP |
$22.83
|
|
|
PR ADRENALECTOMY EXPL W/EXC RETROPERTINEAL TUMOR
|
Professional
|
Both
|
$4,570.00
|
|
|
Service Code
|
HCPCS 60545
|
| Min. Negotiated Rate |
$748.91 |
| Max. Negotiated Rate |
$3,427.50 |
| Rate for Payer: Aetna Commercial |
$1,563.40
|
| Rate for Payer: Aetna Medicare |
$1,166.72
|
| Rate for Payer: BCBS Complete |
$786.36
|
| Rate for Payer: BCBS MAPPO |
$1,166.72
|
| Rate for Payer: BCN Commercial |
$1,865.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,166.72
|
| Rate for Payer: Cash Price |
$3,656.00
|
| Rate for Payer: Cash Price |
$3,656.00
|
| Rate for Payer: Cofinity Commercial |
$1,680.08
|
| Rate for Payer: Cofinity Commercial |
$1,563.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,166.72
|
| Rate for Payer: Healthscope Commercial |
$1,400.06
|
| Rate for Payer: Healthscope Whirlpool |
$1,400.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,225.06
|
| Rate for Payer: Meridian Medicaid |
$786.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,283.39
|
| Rate for Payer: Nomi Health Commercial |
$1,400.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,427.50
|
| Rate for Payer: PACE SWMI |
$1,166.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,166.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$748.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,023.30
|
| Rate for Payer: Priority Health Medicare |
$1,166.72
|
| Rate for Payer: Priority Health Narrow Network |
$2,023.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,166.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,188.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,166.72
|
| Rate for Payer: UHC Exchange |
$2,188.57
|
| Rate for Payer: UHC Medicaid |
$748.91
|
| Rate for Payer: UHCCP DNSP |
$1,166.72
|
| Rate for Payer: UHCCP Medicaid |
$748.91
|
|
|
PR ADRENALECTOMY W/EXPL W/WO BX ABDL/LMBR/DRSAL SPX
|
Professional
|
Both
|
$3,470.00
|
|
|
Service Code
|
HCPCS 60540
|
| Min. Negotiated Rate |
$644.75 |
| Max. Negotiated Rate |
$2,602.50 |
| Rate for Payer: Aetna Commercial |
$1,343.82
|
| Rate for Payer: Aetna Medicare |
$1,002.85
|
| Rate for Payer: BCBS Complete |
$676.99
|
| Rate for Payer: BCBS MAPPO |
$1,002.85
|
| Rate for Payer: BCN Commercial |
$1,619.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,002.85
|
| Rate for Payer: Cash Price |
$2,776.00
|
| Rate for Payer: Cash Price |
$2,776.00
|
| Rate for Payer: Cofinity Commercial |
$1,343.82
|
| Rate for Payer: Cofinity Commercial |
$1,444.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,002.85
|
| Rate for Payer: Healthscope Commercial |
$1,203.42
|
| Rate for Payer: Healthscope Whirlpool |
$1,203.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,052.99
|
| Rate for Payer: Meridian Medicaid |
$676.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,103.13
|
| Rate for Payer: Nomi Health Commercial |
$1,203.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,602.50
|
| Rate for Payer: PACE SWMI |
$1,002.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,002.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$644.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,756.55
|
| Rate for Payer: Priority Health Medicare |
$1,002.85
|
| Rate for Payer: Priority Health Narrow Network |
$1,756.55
|
| Rate for Payer: Railroad Medicare Medicare |
$1,002.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,897.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,002.85
|
| Rate for Payer: UHC Exchange |
$1,897.05
|
| Rate for Payer: UHC Medicaid |
$644.75
|
| Rate for Payer: UHCCP DNSP |
$1,002.85
|
| Rate for Payer: UHCCP Medicaid |
$644.75
|
|
|
PR ADRENALIN EPINEPHRINE INJECT
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS J0171
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$3.75 |
| Rate for Payer: Aetna Commercial |
$0.77
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCN Commercial |
$0.08
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.75
|
|
|
PR ADVANCE CARE PLANNING EA ADDL 30 MINS
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 99498
|
| Min. Negotiated Rate |
$40.47 |
| Max. Negotiated Rate |
$104.95 |
| Rate for Payer: Aetna Commercial |
$83.96
|
| Rate for Payer: Aetna Medicare |
$62.66
|
| Rate for Payer: BCBS Complete |
$42.49
|
| Rate for Payer: BCBS MAPPO |
$62.66
|
| Rate for Payer: BCN Commercial |
$77.01
|
| Rate for Payer: BCN Medicare Advantage |
$62.66
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$90.23
|
| Rate for Payer: Cofinity Commercial |
$83.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.66
|
| Rate for Payer: Healthscope Commercial |
$68.93
|
| Rate for Payer: Healthscope Whirlpool |
$68.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.79
|
| Rate for Payer: Meridian Medicaid |
$42.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.93
|
| Rate for Payer: Nomi Health Commercial |
$75.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
| Rate for Payer: PACE SWMI |
$62.66
|
| Rate for Payer: PHP Medicare Advantage |
$62.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$92.33
|
| Rate for Payer: Priority Health Medicare |
$62.66
|
| Rate for Payer: Priority Health Narrow Network |
$92.33
|
| Rate for Payer: Railroad Medicare Medicare |
$62.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.66
|
| Rate for Payer: UHC Exchange |
$104.95
|
| Rate for Payer: UHC Medicaid |
$40.47
|
| Rate for Payer: UHCCP DNSP |
$62.66
|
| Rate for Payer: UHCCP Medicaid |
$40.47
|
|
|
PR ADVANCE CARE PLANNING FIRST 30 MINS
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 99497
|
| Min. Negotiated Rate |
$41.96 |
| Max. Negotiated Rate |
$111.48 |
| Rate for Payer: Aetna Commercial |
$87.21
|
| Rate for Payer: Aetna Medicare |
$65.08
|
| Rate for Payer: BCBS Complete |
$44.06
|
| Rate for Payer: BCBS MAPPO |
$65.08
|
| Rate for Payer: BCN Commercial |
$81.36
|
| Rate for Payer: BCN Medicare Advantage |
$65.08
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$93.72
|
| Rate for Payer: Cofinity Commercial |
$87.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.08
|
| Rate for Payer: Healthscope Commercial |
$71.59
|
| Rate for Payer: Healthscope Whirlpool |
$71.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.33
|
| Rate for Payer: Meridian Medicaid |
$44.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.59
|
| Rate for Payer: Nomi Health Commercial |
$78.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.50
|
| Rate for Payer: PACE SWMI |
$65.08
|
| Rate for Payer: PHP Medicare Advantage |
$65.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$97.57
|
| Rate for Payer: Priority Health Medicare |
$65.08
|
| Rate for Payer: Priority Health Narrow Network |
$97.57
|
| Rate for Payer: Railroad Medicare Medicare |
$65.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$111.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.08
|
| Rate for Payer: UHC Exchange |
$111.48
|
| Rate for Payer: UHC Medicaid |
$41.96
|
| Rate for Payer: UHCCP DNSP |
$65.08
|
| Rate for Payer: UHCCP Medicaid |
$41.96
|
|
|
PR AEP HEARING STATUS DETER BROADBAND STIMULI I&R
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 92651
|
| Min. Negotiated Rate |
$76.32 |
| Max. Negotiated Rate |
$145.54 |
| Rate for Payer: Aetna Commercial |
$102.27
|
| Rate for Payer: Aetna Medicare |
$76.32
|
| Rate for Payer: BCBS MAPPO |
$76.32
|
| Rate for Payer: BCN Commercial |
$118.03
|
| Rate for Payer: BCN Medicare Advantage |
$76.32
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cofinity Commercial |
$102.27
|
| Rate for Payer: Cofinity Commercial |
$109.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.32
|
| Rate for Payer: Healthscope Commercial |
$91.58
|
| Rate for Payer: Healthscope Whirlpool |
$91.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.95
|
| Rate for Payer: Nomi Health Commercial |
$91.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.50
|
| Rate for Payer: PACE SWMI |
$76.32
|
| Rate for Payer: PHP Medicare Advantage |
$76.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$108.84
|
| Rate for Payer: Priority Health Medicare |
$76.32
|
| Rate for Payer: Priority Health Narrow Network |
$108.84
|
| Rate for Payer: Railroad Medicare Medicare |
$76.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$76.32
|
| Rate for Payer: UHC Exchange |
$145.54
|
| Rate for Payer: UHCCP DNSP |
$76.32
|
|
|
PR AEP NEURODIAGNOSTIC INTERPRETATION AND REPORT
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
HCPCS 92653
|
| Min. Negotiated Rate |
$76.51 |
| Max. Negotiated Rate |
$142.16 |
| Rate for Payer: Aetna Commercial |
$102.52
|
| Rate for Payer: Aetna Medicare |
$76.51
|
| Rate for Payer: BCBS MAPPO |
$76.51
|
| Rate for Payer: BCN Commercial |
$121.01
|
| Rate for Payer: BCN Medicare Advantage |
$76.51
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cofinity Commercial |
$102.52
|
| Rate for Payer: Cofinity Commercial |
$110.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.51
|
| Rate for Payer: Healthscope Commercial |
$91.81
|
| Rate for Payer: Healthscope Whirlpool |
$91.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.16
|
| Rate for Payer: Nomi Health Commercial |
$91.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.50
|
| Rate for Payer: PACE SWMI |
$76.51
|
| Rate for Payer: PHP Medicare Advantage |
$76.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$111.59
|
| Rate for Payer: Priority Health Medicare |
$76.51
|
| Rate for Payer: Priority Health Narrow Network |
$111.59
|
| Rate for Payer: Railroad Medicare Medicare |
$76.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$76.51
|
| Rate for Payer: UHC Exchange |
$142.16
|
| Rate for Payer: UHCCP DNSP |
$76.51
|
|
|
PR AEP SCR AUDITORY POTENTIAL W/STIMULI AUTO ALYS
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 92650
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$46.53 |
| Rate for Payer: Aetna Commercial |
$30.47
|
| Rate for Payer: BCBS Complete |
$14.31
|
| Rate for Payer: BCN Commercial |
$39.34
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Meridian Medicaid |
$14.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$36.27
|
| Rate for Payer: Priority Health Narrow Network |
$36.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.53
|
| Rate for Payer: UHC Exchange |
$46.53
|
| Rate for Payer: UHC Medicaid |
$13.63
|
| Rate for Payer: UHCCP Medicaid |
$13.63
|
|
|
PR AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 92652
|
| Min. Negotiated Rate |
$103.25 |
| Max. Negotiated Rate |
$193.39 |
| Rate for Payer: Aetna Commercial |
$138.35
|
| Rate for Payer: Aetna Medicare |
$103.25
|
| Rate for Payer: BCBS MAPPO |
$103.25
|
| Rate for Payer: BCN Commercial |
$161.85
|
| Rate for Payer: BCN Medicare Advantage |
$103.25
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$138.35
|
| Rate for Payer: Cofinity Commercial |
$148.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.25
|
| Rate for Payer: Healthscope Commercial |
$123.90
|
| Rate for Payer: Healthscope Whirlpool |
$123.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$113.58
|
| Rate for Payer: Nomi Health Commercial |
$123.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.00
|
| Rate for Payer: PACE SWMI |
$103.25
|
| Rate for Payer: PHP Medicare Advantage |
$103.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$149.26
|
| Rate for Payer: Priority Health Medicare |
$103.25
|
| Rate for Payer: Priority Health Narrow Network |
$149.26
|
| Rate for Payer: Railroad Medicare Medicare |
$103.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$193.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$103.25
|
| Rate for Payer: UHC Exchange |
$193.39
|
| Rate for Payer: UHCCP DNSP |
$103.25
|
|
|
PR AFO ANKLE GAUNTLET PRE OTS
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS L1902
|
| Min. Negotiated Rate |
$29.91 |
| Max. Negotiated Rate |
$132.09 |
| Rate for Payer: Aetna Commercial |
$122.92
|
| Rate for Payer: Aetna Medicare |
$91.73
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCBS MAPPO |
$91.73
|
| Rate for Payer: BCN Commercial |
$87.83
|
| Rate for Payer: BCN Medicare Advantage |
$91.73
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$132.09
|
| Rate for Payer: Cofinity Commercial |
$122.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.73
|
| Rate for Payer: Healthscope Commercial |
$110.08
|
| Rate for Payer: Healthscope Whirlpool |
$110.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.90
|
| Rate for Payer: Nomi Health Commercial |
$110.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.25
|
| Rate for Payer: PACE SWMI |
$91.73
|
| Rate for Payer: PHP Medicare Advantage |
$91.73
|
| Rate for Payer: Priority Health Medicare |
$91.73
|
| Rate for Payer: Railroad Medicare Medicare |
$91.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.73
|
| Rate for Payer: UHC Exchange |
$29.91
|
| Rate for Payer: UHCCP DNSP |
$91.73
|
|
|
PR AFO MULTILIG ANK SUP PRE OTS
|
Professional
|
Both
|
$113.00
|
|
|
Service Code
|
HCPCS L1906
|
| Min. Negotiated Rate |
$45.06 |
| Max. Negotiated Rate |
$199.01 |
| Rate for Payer: Aetna Commercial |
$185.19
|
| Rate for Payer: Aetna Medicare |
$138.20
|
| Rate for Payer: BCBS Complete |
$45.20
|
| Rate for Payer: BCBS MAPPO |
$138.20
|
| Rate for Payer: BCN Commercial |
$132.31
|
| Rate for Payer: BCN Medicare Advantage |
$138.20
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cofinity Commercial |
$199.01
|
| Rate for Payer: Cofinity Commercial |
$185.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.20
|
| Rate for Payer: Healthscope Commercial |
$165.84
|
| Rate for Payer: Healthscope Whirlpool |
$165.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$152.02
|
| Rate for Payer: Nomi Health Commercial |
$165.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.75
|
| Rate for Payer: PACE SWMI |
$138.20
|
| Rate for Payer: PHP Medicare Advantage |
$138.20
|
| Rate for Payer: Priority Health Medicare |
$138.20
|
| Rate for Payer: Railroad Medicare Medicare |
$138.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$138.20
|
| Rate for Payer: UHC Exchange |
$45.06
|
| Rate for Payer: UHCCP DNSP |
$138.20
|
|
|
PR AIIV4 VACC INACTIVATED PRSRV FR 0.5ML DOS IM USE
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 90694
|
| Min. Negotiated Rate |
$67.98 |
| Max. Negotiated Rate |
$140.25 |
| Rate for Payer: Aetna Commercial |
$77.36
|
| Rate for Payer: BCBS Trust/PPO |
$67.98
|
| Rate for Payer: BCN Commercial |
$77.36
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$77.36
|
| Rate for Payer: UHC Exchange |
$77.36
|
|
|
PR AK SLEEVE SUSP NEOPRENE/EQUA
|
Professional
|
Both
|
$164.00
|
|
|
Service Code
|
HCPCS L5695
|
| Min. Negotiated Rate |
$65.10 |
| Max. Negotiated Rate |
$287.50 |
| Rate for Payer: Aetna Commercial |
$267.53
|
| Rate for Payer: Aetna Medicare |
$199.65
|
| Rate for Payer: BCBS Complete |
$65.60
|
| Rate for Payer: BCBS MAPPO |
$199.65
|
| Rate for Payer: BCN Commercial |
$191.15
|
| Rate for Payer: BCN Medicare Advantage |
$199.65
|
| Rate for Payer: Cash Price |
$131.20
|
| Rate for Payer: Cash Price |
$131.20
|
| Rate for Payer: Cofinity Commercial |
$267.53
|
| Rate for Payer: Cofinity Commercial |
$287.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.65
|
| Rate for Payer: Healthscope Commercial |
$239.58
|
| Rate for Payer: Healthscope Whirlpool |
$239.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.62
|
| Rate for Payer: Nomi Health Commercial |
$239.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.00
|
| Rate for Payer: PACE SWMI |
$199.65
|
| Rate for Payer: PHP Medicare Advantage |
$199.65
|
| Rate for Payer: Priority Health Medicare |
$199.65
|
| Rate for Payer: Railroad Medicare Medicare |
$199.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.65
|
| Rate for Payer: UHC Exchange |
$65.10
|
| Rate for Payer: UHCCP DNSP |
$199.65
|
|
|
PR ALBUTEROL IPRATROP NON-COMP
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS J7620
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$1.50 |
| Rate for Payer: Aetna Commercial |
$0.28
|
| Rate for Payer: Aetna Medicare |
$0.21
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: BCBS MAPPO |
$0.21
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: BCN Medicare Advantage |
$0.21
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cofinity Commercial |
$0.30
|
| Rate for Payer: Cofinity Commercial |
$0.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.21
|
| Rate for Payer: Healthscope Commercial |
$0.25
|
| Rate for Payer: Healthscope Whirlpool |
$0.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.23
|
| Rate for Payer: Nomi Health Commercial |
$0.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.50
|
| Rate for Payer: PACE SWMI |
$0.21
|
| Rate for Payer: PHP Medicare Advantage |
$0.21
|
| Rate for Payer: Priority Health Medicare |
$0.21
|
| Rate for Payer: Railroad Medicare Medicare |
$0.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.21
|
| Rate for Payer: UHC Exchange |
$0.20
|
| Rate for Payer: UHCCP DNSP |
$0.21
|
|
|
PR ALBUTEROL NON-COMP CON
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS J7611
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$1.50 |
| Rate for Payer: Aetna Commercial |
$0.32
|
| Rate for Payer: Aetna Medicare |
$0.24
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: BCBS MAPPO |
$0.24
|
| Rate for Payer: BCN Commercial |
$0.09
|
| Rate for Payer: BCN Medicare Advantage |
$0.24
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cofinity Commercial |
$0.35
|
| Rate for Payer: Cofinity Commercial |
$0.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.24
|
| Rate for Payer: Healthscope Commercial |
$0.29
|
| Rate for Payer: Healthscope Whirlpool |
$0.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.26
|
| Rate for Payer: Nomi Health Commercial |
$0.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.50
|
| Rate for Payer: PACE SWMI |
$0.24
|
| Rate for Payer: PHP Medicare Advantage |
$0.24
|
| Rate for Payer: Priority Health Medicare |
$0.24
|
| Rate for Payer: Railroad Medicare Medicare |
$0.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.24
|
| Rate for Payer: UHC Exchange |
$0.26
|
| Rate for Payer: UHCCP DNSP |
$0.24
|
|
|
PR ALBUTEROL NON-COMP UNIT
|
Professional
|
Both
|
$2.00
|
|
|
Service Code
|
HCPCS J7613
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1.50 |
| Rate for Payer: Aetna Commercial |
$0.11
|
| Rate for Payer: Aetna Medicare |
$0.08
|
| Rate for Payer: BCBS Complete |
$0.80
|
| Rate for Payer: BCBS MAPPO |
$0.08
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.08
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cash Price |
$1.60
|
| Rate for Payer: Cofinity Commercial |
$0.12
|
| Rate for Payer: Cofinity Commercial |
$0.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.08
|
| Rate for Payer: Healthscope Commercial |
$0.10
|
| Rate for Payer: Healthscope Whirlpool |
$0.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.09
|
| Rate for Payer: Nomi Health Commercial |
$0.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.50
|
| Rate for Payer: PACE SWMI |
$0.08
|
| Rate for Payer: PHP Medicare Advantage |
$0.08
|
| Rate for Payer: Priority Health Medicare |
$0.08
|
| Rate for Payer: Railroad Medicare Medicare |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$0.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.07
|
| Rate for Payer: UHCCP DNSP |
$0.08
|
|
|
PR ALCOHOL AND/OR DRUG SERVICES
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS H0015
|
| Min. Negotiated Rate |
$101.60 |
| Max. Negotiated Rate |
$190.50 |
| Rate for Payer: Aetna Commercial |
$134.33
|
| Rate for Payer: BCBS Complete |
$101.60
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.50
|
|
|
PR ALCOHOL/SUBS INTERV 15-30MN
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
HCPCS G0396
|
| Min. Negotiated Rate |
$18.53 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: Aetna Commercial |
$38.66
|
| Rate for Payer: Aetna Medicare |
$28.85
|
| Rate for Payer: BCBS Complete |
$19.46
|
| Rate for Payer: BCBS MAPPO |
$28.85
|
| Rate for Payer: BCN Commercial |
$47.31
|
| Rate for Payer: BCN Medicare Advantage |
$28.85
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$41.54
|
| Rate for Payer: Cofinity Commercial |
$38.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.85
|
| Rate for Payer: Healthscope Commercial |
$34.62
|
| Rate for Payer: Healthscope Whirlpool |
$34.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.29
|
| Rate for Payer: Meridian Medicaid |
$19.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.73
|
| Rate for Payer: Nomi Health Commercial |
$34.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.50
|
| Rate for Payer: PACE SWMI |
$28.85
|
| Rate for Payer: PHP Medicare Advantage |
$28.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$42.56
|
| Rate for Payer: Priority Health Medicare |
$28.85
|
| Rate for Payer: Priority Health Narrow Network |
$42.56
|
| Rate for Payer: Railroad Medicare Medicare |
$28.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.85
|
| Rate for Payer: UHC Exchange |
$47.13
|
| Rate for Payer: UHC Medicaid |
$18.53
|
| Rate for Payer: UHCCP DNSP |
$28.85
|
| Rate for Payer: UHCCP Medicaid |
$18.53
|
|
|
PR ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 99408
|
| Min. Negotiated Rate |
$17.68 |
| Max. Negotiated Rate |
$47.60 |
| Rate for Payer: Aetna Commercial |
$33.63
|
| Rate for Payer: BCBS Complete |
$18.56
|
| Rate for Payer: BCN Commercial |
$47.31
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Meridian Medicaid |
$18.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$42.56
|
| Rate for Payer: Priority Health Narrow Network |
$42.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.60
|
| Rate for Payer: UHC Exchange |
$47.60
|
| Rate for Payer: UHC Medicaid |
$17.68
|
| Rate for Payer: UHCCP Medicaid |
$17.68
|
|
|
PR ALCOHOL/SUBSTANCE SCREEN & INTERVENTION >30 MIN
|
Professional
|
Both
|
$107.00
|
|
|
Service Code
|
HCPCS 99409
|
| Min. Negotiated Rate |
$35.36 |
| Max. Negotiated Rate |
$95.69 |
| Rate for Payer: Aetna Commercial |
$67.61
|
| Rate for Payer: BCBS Complete |
$37.13
|
| Rate for Payer: BCN Commercial |
$93.62
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Meridian Medicaid |
$37.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$84.21
|
| Rate for Payer: Priority Health Narrow Network |
$84.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.69
|
| Rate for Payer: UHC Exchange |
$95.69
|
| Rate for Payer: UHC Medicaid |
$35.36
|
| Rate for Payer: UHCCP Medicaid |
$35.36
|
|
|
PR ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED
|
Professional
|
Both
|
$504.00
|
|
|
Service Code
|
HCPCS 20930
|
| Min. Negotiated Rate |
$137.26 |
| Max. Negotiated Rate |
$378.00 |
| Rate for Payer: Aetna Commercial |
$155.86
|
| Rate for Payer: BCBS Complete |
$201.60
|
| Rate for Payer: BCN Commercial |
$137.26
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: Cash Price |
$403.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$188.45
|
| Rate for Payer: Priority Health Narrow Network |
$188.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$207.06
|
| Rate for Payer: UHC Exchange |
$207.06
|
|
|
PR ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL
|
Professional
|
Both
|
$459.00
|
|
|
Service Code
|
HCPCS 20931
|
| Min. Negotiated Rate |
$62.62 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Aetna Commercial |
$132.70
|
| Rate for Payer: Aetna Medicare |
$99.03
|
| Rate for Payer: BCBS Complete |
$65.75
|
| Rate for Payer: BCBS MAPPO |
$99.03
|
| Rate for Payer: BCN Commercial |
$182.18
|
| Rate for Payer: BCN Medicare Advantage |
$99.03
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cofinity Commercial |
$142.60
|
| Rate for Payer: Cofinity Commercial |
$132.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.03
|
| Rate for Payer: Healthscope Commercial |
$118.84
|
| Rate for Payer: Healthscope Whirlpool |
$118.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.98
|
| Rate for Payer: Meridian Medicaid |
$65.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.93
|
| Rate for Payer: Nomi Health Commercial |
$118.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$344.25
|
| Rate for Payer: PACE SWMI |
$99.03
|
| Rate for Payer: PHP Medicare Advantage |
$99.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$177.26
|
| Rate for Payer: Priority Health Medicare |
$99.03
|
| Rate for Payer: Priority Health Narrow Network |
$177.26
|
| Rate for Payer: Railroad Medicare Medicare |
$99.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$197.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$99.03
|
| Rate for Payer: UHC Exchange |
$197.52
|
| Rate for Payer: UHC Medicaid |
$62.62
|
| Rate for Payer: UHCCP DNSP |
$99.03
|
| Rate for Payer: UHCCP Medicaid |
$62.62
|
|
