|
PR ANES XTRPRTL PX LWR ABD W/UR TRACT ADRENALECTOMY
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS 00866
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
|
|
PR ANES XTRPRTL PX LWR ABD W/UR TRACT RAD PRST8ECT
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS 00865
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$5.25 |
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.25
|
|
|
PR ANES XTRPRTL PX LWR ABD W/UR TRACT RENAL PX
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS 00862
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$5.25 |
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.25
|
|
|
PR ANES XTRPRTL PX LWR ABD W/UR TRACT RENAL TRANSPL
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS 00868
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.50
|
|
|
PR ANES XTRPRTL PX LWR ABD W/UR TRACT TOT CSTC
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 00864
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.00
|
|
|
PR ANES XTRPRTL PX LWR ABD W/UR TRC CYSTOLITHOTOMY
|
Professional
|
Both
|
$5.00
|
|
|
Service Code
|
HCPCS 00870
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$3.75 |
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: Cash Price |
$4.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.75
|
|
|
PR ANKLE CONTROL ORTHO PRE OTS
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
HCPCS L4350
|
| Min. Negotiated Rate |
$38.78 |
| Max. Negotiated Rate |
$171.22 |
| Rate for Payer: Aetna Commercial |
$159.33
|
| Rate for Payer: Aetna Medicare |
$118.90
|
| Rate for Payer: BCBS MAPPO |
$118.90
|
| Rate for Payer: BCN Commercial |
$113.84
|
| Rate for Payer: BCN Medicare Advantage |
$118.90
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cofinity Commercial |
$171.22
|
| Rate for Payer: Cofinity Commercial |
$159.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.90
|
| Rate for Payer: Healthscope Commercial |
$142.68
|
| Rate for Payer: Healthscope Whirlpool |
$142.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.79
|
| Rate for Payer: Nomi Health Commercial |
$142.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.50
|
| Rate for Payer: PACE SWMI |
$118.90
|
| Rate for Payer: PHP Medicare Advantage |
$118.90
|
| Rate for Payer: Priority Health Medicare |
$118.90
|
| Rate for Payer: Railroad Medicare Medicare |
$118.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.90
|
| Rate for Payer: UHC Exchange |
$38.78
|
| Rate for Payer: UHCCP DNSP |
$118.90
|
|
|
PR ANKLE DISARTICULATION
|
Professional
|
Both
|
$1,376.00
|
|
|
Service Code
|
HCPCS 27889
|
| Min. Negotiated Rate |
$381.06 |
| Max. Negotiated Rate |
$1,139.98 |
| Rate for Payer: Aetna Commercial |
$794.51
|
| Rate for Payer: Aetna Medicare |
$592.92
|
| Rate for Payer: BCBS Complete |
$400.11
|
| Rate for Payer: BCBS MAPPO |
$592.92
|
| Rate for Payer: BCN Commercial |
$959.11
|
| Rate for Payer: BCN Medicare Advantage |
$592.92
|
| Rate for Payer: Cash Price |
$1,100.80
|
| Rate for Payer: Cash Price |
$1,100.80
|
| Rate for Payer: Cofinity Commercial |
$794.51
|
| Rate for Payer: Cofinity Commercial |
$853.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$592.92
|
| Rate for Payer: Healthscope Commercial |
$711.50
|
| Rate for Payer: Healthscope Whirlpool |
$711.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$622.57
|
| Rate for Payer: Meridian Medicaid |
$400.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$652.21
|
| Rate for Payer: Nomi Health Commercial |
$711.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,032.00
|
| Rate for Payer: PACE SWMI |
$592.92
|
| Rate for Payer: PHP Medicare Advantage |
$592.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$381.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,025.26
|
| Rate for Payer: Priority Health Medicare |
$592.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,025.26
|
| Rate for Payer: Railroad Medicare Medicare |
$592.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,139.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$592.92
|
| Rate for Payer: UHC Exchange |
$1,139.98
|
| Rate for Payer: UHC Medicaid |
$381.06
|
| Rate for Payer: UHCCP DNSP |
$592.92
|
| Rate for Payer: UHCCP Medicaid |
$381.06
|
|
|
PR ANN BREAST EXAM
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS S0613
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$25.00 |
| Rate for Payer: Aetna Commercial |
$25.00
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCN Commercial |
$19.15
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
|
|
PR ANNUAL GYNECOLOGICAL EXAMINA
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
HCPCS S0612
|
| Min. Negotiated Rate |
$33.20 |
| Max. Negotiated Rate |
$65.39 |
| Rate for Payer: Aetna Commercial |
$55.00
|
| Rate for Payer: BCBS Complete |
$33.20
|
| Rate for Payer: BCN Commercial |
$65.39
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.25
|
|
|
PR ANOGENITAL XM MAGNIFY CHILD/SUSPECT TRAUMA W IMG
|
Professional
|
Both
|
$276.00
|
|
|
Service Code
|
HCPCS 99170
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna Commercial |
$95.38
|
| Rate for Payer: Aetna Medicare |
$71.18
|
| Rate for Payer: BCBS Complete |
$48.09
|
| Rate for Payer: BCBS MAPPO |
$71.18
|
| Rate for Payer: BCN Commercial |
$124.99
|
| Rate for Payer: BCN Medicare Advantage |
$71.18
|
| Rate for Payer: Cash Price |
$220.80
|
| Rate for Payer: Cash Price |
$220.80
|
| Rate for Payer: Cofinity Commercial |
$95.38
|
| Rate for Payer: Cofinity Commercial |
$102.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.18
|
| Rate for Payer: Healthscope Commercial |
$85.42
|
| Rate for Payer: Healthscope Whirlpool |
$85.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.74
|
| Rate for Payer: Meridian Medicaid |
$48.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.30
|
| Rate for Payer: Nomi Health Commercial |
$85.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.00
|
| Rate for Payer: PACE SWMI |
$71.18
|
| Rate for Payer: PHP Medicare Advantage |
$71.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$115.27
|
| Rate for Payer: Priority Health Medicare |
$71.18
|
| Rate for Payer: Priority Health Narrow Network |
$115.27
|
| Rate for Payer: Railroad Medicare Medicare |
$71.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$139.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.18
|
| Rate for Payer: UHC Exchange |
$139.97
|
| Rate for Payer: UHC Medicaid |
$45.80
|
| Rate for Payer: UHCCP DNSP |
$71.18
|
| Rate for Payer: UHCCP Medicaid |
$45.80
|
|
|
PR ANOPLASTY PLASTIC OPERATION STRICTURE ADULT
|
Professional
|
Both
|
$1,389.00
|
|
|
Service Code
|
HCPCS 46700
|
| Min. Negotiated Rate |
$407.90 |
| Max. Negotiated Rate |
$1,205.62 |
| Rate for Payer: Aetna Commercial |
$835.13
|
| Rate for Payer: Aetna Medicare |
$623.23
|
| Rate for Payer: BCBS Complete |
$428.30
|
| Rate for Payer: BCBS MAPPO |
$623.23
|
| Rate for Payer: BCN Commercial |
$989.49
|
| Rate for Payer: BCN Medicare Advantage |
$623.23
|
| Rate for Payer: Cash Price |
$1,111.20
|
| Rate for Payer: Cash Price |
$1,111.20
|
| Rate for Payer: Cofinity Commercial |
$897.45
|
| Rate for Payer: Cofinity Commercial |
$835.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$623.23
|
| Rate for Payer: Healthscope Commercial |
$747.88
|
| Rate for Payer: Healthscope Whirlpool |
$747.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$654.39
|
| Rate for Payer: Meridian Medicaid |
$428.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$685.55
|
| Rate for Payer: Nomi Health Commercial |
$747.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,041.75
|
| Rate for Payer: PACE SWMI |
$623.23
|
| Rate for Payer: PHP Medicare Advantage |
$623.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$407.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,205.62
|
| Rate for Payer: Priority Health Medicare |
$623.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,205.62
|
| Rate for Payer: Railroad Medicare Medicare |
$623.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,150.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$623.23
|
| Rate for Payer: UHC Exchange |
$1,150.58
|
| Rate for Payer: UHC Medicaid |
$407.90
|
| Rate for Payer: UHCCP DNSP |
$623.23
|
| Rate for Payer: UHCCP Medicaid |
$407.90
|
|
|
PR ANOPLASTY PLASTIC OPERATION STRICTURE INFANT
|
Professional
|
Both
|
$1,468.00
|
|
|
Service Code
|
HCPCS 46705
|
| Min. Negotiated Rate |
$367.64 |
| Max. Negotiated Rate |
$1,101.00 |
| Rate for Payer: Aetna Commercial |
$752.16
|
| Rate for Payer: Aetna Medicare |
$561.31
|
| Rate for Payer: BCBS Complete |
$386.02
|
| Rate for Payer: BCBS MAPPO |
$561.31
|
| Rate for Payer: BCN Commercial |
$870.97
|
| Rate for Payer: BCN Medicare Advantage |
$561.31
|
| Rate for Payer: Cash Price |
$1,174.40
|
| Rate for Payer: Cash Price |
$1,174.40
|
| Rate for Payer: Cofinity Commercial |
$808.29
|
| Rate for Payer: Cofinity Commercial |
$752.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.31
|
| Rate for Payer: Healthscope Commercial |
$673.57
|
| Rate for Payer: Healthscope Whirlpool |
$673.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.38
|
| Rate for Payer: Meridian Medicaid |
$386.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$617.44
|
| Rate for Payer: Nomi Health Commercial |
$673.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,101.00
|
| Rate for Payer: PACE SWMI |
$561.31
|
| Rate for Payer: PHP Medicare Advantage |
$561.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,061.22
|
| Rate for Payer: Priority Health Medicare |
$561.31
|
| Rate for Payer: Priority Health Narrow Network |
$1,061.22
|
| Rate for Payer: Railroad Medicare Medicare |
$561.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$988.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$561.31
|
| Rate for Payer: UHC Exchange |
$988.02
|
| Rate for Payer: UHC Medicaid |
$367.64
|
| Rate for Payer: UHCCP DNSP |
$561.31
|
| Rate for Payer: UHCCP Medicaid |
$367.64
|
|
|
PR ANORECTAL MANOMETRY
|
Professional
|
Both
|
$405.00
|
|
|
Service Code
|
HCPCS 91122
|
| Min. Negotiated Rate |
$162.00 |
| Max. Negotiated Rate |
$406.85 |
| Rate for Payer: Aetna Commercial |
$290.91
|
| Rate for Payer: BCBS Complete |
$162.00
|
| Rate for Payer: BCN Commercial |
$406.85
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.75
|
|
|
PR ANORECTAL MYOMECTOMY
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 45108
|
| Min. Negotiated Rate |
$237.71 |
| Max. Negotiated Rate |
$1,286.25 |
| Rate for Payer: Aetna Commercial |
$488.32
|
| Rate for Payer: Aetna Medicare |
$364.42
|
| Rate for Payer: BCBS Complete |
$249.60
|
| Rate for Payer: BCBS MAPPO |
$364.42
|
| Rate for Payer: BCN Commercial |
$570.19
|
| Rate for Payer: BCN Medicare Advantage |
$364.42
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Commercial |
$524.76
|
| Rate for Payer: Cofinity Commercial |
$488.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$364.42
|
| Rate for Payer: Healthscope Commercial |
$437.30
|
| Rate for Payer: Healthscope Whirlpool |
$437.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$382.64
|
| Rate for Payer: Meridian Medicaid |
$249.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$400.86
|
| Rate for Payer: Nomi Health Commercial |
$437.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,286.25
|
| Rate for Payer: PACE SWMI |
$364.42
|
| Rate for Payer: PHP Medicare Advantage |
$364.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$694.74
|
| Rate for Payer: Priority Health Medicare |
$364.42
|
| Rate for Payer: Priority Health Narrow Network |
$694.74
|
| Rate for Payer: Railroad Medicare Medicare |
$364.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$652.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$364.42
|
| Rate for Payer: UHC Exchange |
$652.74
|
| Rate for Payer: UHC Medicaid |
$237.71
|
| Rate for Payer: UHCCP DNSP |
$364.42
|
| Rate for Payer: UHCCP Medicaid |
$237.71
|
|
|
PR ANOSCOPY ABLATION LESION
|
Professional
|
Both
|
$690.00
|
|
|
Service Code
|
HCPCS 46615
|
| Min. Negotiated Rate |
$53.46 |
| Max. Negotiated Rate |
$517.50 |
| Rate for Payer: Aetna Commercial |
$110.28
|
| Rate for Payer: Aetna Medicare |
$82.30
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$82.30
|
| Rate for Payer: BCN Commercial |
$135.45
|
| Rate for Payer: BCN Medicare Advantage |
$82.30
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cash Price |
$552.00
|
| Rate for Payer: Cofinity Commercial |
$118.51
|
| Rate for Payer: Cofinity Commercial |
$110.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.30
|
| Rate for Payer: Healthscope Commercial |
$98.76
|
| Rate for Payer: Healthscope Whirlpool |
$98.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.42
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$90.53
|
| Rate for Payer: Nomi Health Commercial |
$98.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.50
|
| Rate for Payer: PACE SWMI |
$82.30
|
| Rate for Payer: PHP Medicare Advantage |
$82.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$165.03
|
| Rate for Payer: Priority Health Medicare |
$82.30
|
| Rate for Payer: Priority Health Narrow Network |
$165.03
|
| Rate for Payer: Railroad Medicare Medicare |
$82.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$82.30
|
| Rate for Payer: UHC Exchange |
$160.81
|
| Rate for Payer: UHC Medicaid |
$53.46
|
| Rate for Payer: UHCCP DNSP |
$82.30
|
| Rate for Payer: UHCCP Medicaid |
$53.46
|
|
|
PR ANOSCOPY CONTROL BLEEDING
|
Professional
|
Both
|
$658.00
|
|
|
Service Code
|
HCPCS 46614
|
| Min. Negotiated Rate |
$39.19 |
| Max. Negotiated Rate |
$493.50 |
| Rate for Payer: Aetna Commercial |
$80.55
|
| Rate for Payer: Aetna Medicare |
$60.11
|
| Rate for Payer: BCBS Complete |
$41.15
|
| Rate for Payer: BCBS MAPPO |
$60.11
|
| Rate for Payer: BCN Commercial |
$97.11
|
| Rate for Payer: BCN Medicare Advantage |
$60.11
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cofinity Commercial |
$86.56
|
| Rate for Payer: Cofinity Commercial |
$80.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.11
|
| Rate for Payer: Healthscope Commercial |
$72.13
|
| Rate for Payer: Healthscope Whirlpool |
$72.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.12
|
| Rate for Payer: Meridian Medicaid |
$41.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$66.12
|
| Rate for Payer: Nomi Health Commercial |
$72.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$493.50
|
| Rate for Payer: PACE SWMI |
$60.11
|
| Rate for Payer: PHP Medicare Advantage |
$60.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$118.33
|
| Rate for Payer: Priority Health Medicare |
$60.11
|
| Rate for Payer: Priority Health Narrow Network |
$118.33
|
| Rate for Payer: Railroad Medicare Medicare |
$60.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$112.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$60.11
|
| Rate for Payer: UHC Exchange |
$112.42
|
| Rate for Payer: UHC Medicaid |
$39.19
|
| Rate for Payer: UHCCP DNSP |
$60.11
|
| Rate for Payer: UHCCP Medicaid |
$39.19
|
|
|
PR ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
HCPCS 46600
|
| Min. Negotiated Rate |
$25.77 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Aetna Commercial |
$52.33
|
| Rate for Payer: Aetna Medicare |
$39.05
|
| Rate for Payer: BCBS Complete |
$27.06
|
| Rate for Payer: BCBS MAPPO |
$39.05
|
| Rate for Payer: BCN Commercial |
$49.09
|
| Rate for Payer: BCN Medicare Advantage |
$39.05
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$56.23
|
| Rate for Payer: Cofinity Commercial |
$52.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.05
|
| Rate for Payer: Healthscope Commercial |
$46.86
|
| Rate for Payer: Healthscope Whirlpool |
$46.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.00
|
| Rate for Payer: Meridian Medicaid |
$27.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.95
|
| Rate for Payer: Nomi Health Commercial |
$46.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.00
|
| Rate for Payer: PACE SWMI |
$39.05
|
| Rate for Payer: PHP Medicare Advantage |
$39.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$75.84
|
| Rate for Payer: Priority Health Medicare |
$39.05
|
| Rate for Payer: Priority Health Narrow Network |
$75.84
|
| Rate for Payer: Railroad Medicare Medicare |
$39.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.05
|
| Rate for Payer: UHC Exchange |
$70.64
|
| Rate for Payer: UHC Medicaid |
$25.77
|
| Rate for Payer: UHCCP DNSP |
$39.05
|
| Rate for Payer: UHCCP Medicaid |
$25.77
|
|
|
PR ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT
|
Professional
|
Both
|
$280.00
|
|
|
Service Code
|
HCPCS 46601
|
| Min. Negotiated Rate |
$54.53 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$112.72
|
| Rate for Payer: Aetna Medicare |
$84.12
|
| Rate for Payer: BCBS Complete |
$57.26
|
| Rate for Payer: BCBS MAPPO |
$84.12
|
| Rate for Payer: BCN Commercial |
$139.93
|
| Rate for Payer: BCN Medicare Advantage |
$84.12
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Cash Price |
$224.00
|
| Rate for Payer: Cofinity Commercial |
$121.13
|
| Rate for Payer: Cofinity Commercial |
$112.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.12
|
| Rate for Payer: Healthscope Commercial |
$100.94
|
| Rate for Payer: Healthscope Whirlpool |
$100.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.33
|
| Rate for Payer: Meridian Medicaid |
$57.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.53
|
| Rate for Payer: Nomi Health Commercial |
$100.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.00
|
| Rate for Payer: PACE SWMI |
$84.12
|
| Rate for Payer: PHP Medicare Advantage |
$84.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$170.49
|
| Rate for Payer: Priority Health Medicare |
$84.12
|
| Rate for Payer: Priority Health Narrow Network |
$170.49
|
| Rate for Payer: Railroad Medicare Medicare |
$84.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$165.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$84.12
|
| Rate for Payer: UHC Exchange |
$165.25
|
| Rate for Payer: UHC Medicaid |
$54.53
|
| Rate for Payer: UHCCP DNSP |
$84.12
|
| Rate for Payer: UHCCP Medicaid |
$54.53
|
|
|
PR ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX
|
Professional
|
Both
|
$297.00
|
|
|
Service Code
|
HCPCS 46607
|
| Min. Negotiated Rate |
$72.21 |
| Max. Negotiated Rate |
$225.12 |
| Rate for Payer: Aetna Commercial |
$149.80
|
| Rate for Payer: Aetna Medicare |
$111.79
|
| Rate for Payer: BCBS Complete |
$75.82
|
| Rate for Payer: BCBS MAPPO |
$111.79
|
| Rate for Payer: BCN Commercial |
$184.75
|
| Rate for Payer: BCN Medicare Advantage |
$111.79
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cash Price |
$237.60
|
| Rate for Payer: Cofinity Commercial |
$160.98
|
| Rate for Payer: Cofinity Commercial |
$149.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.79
|
| Rate for Payer: Healthscope Commercial |
$134.15
|
| Rate for Payer: Healthscope Whirlpool |
$134.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$117.38
|
| Rate for Payer: Meridian Medicaid |
$75.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$122.97
|
| Rate for Payer: Nomi Health Commercial |
$134.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.75
|
| Rate for Payer: PACE SWMI |
$111.79
|
| Rate for Payer: PHP Medicare Advantage |
$111.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$225.12
|
| Rate for Payer: Priority Health Medicare |
$111.79
|
| Rate for Payer: Priority Health Narrow Network |
$225.12
|
| Rate for Payer: Railroad Medicare Medicare |
$111.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$222.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$111.79
|
| Rate for Payer: UHC Exchange |
$222.95
|
| Rate for Payer: UHC Medicaid |
$72.21
|
| Rate for Payer: UHCCP DNSP |
$111.79
|
| Rate for Payer: UHCCP Medicaid |
$72.21
|
|
|
PR ANOSCOPY W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$378.00
|
|
|
Service Code
|
HCPCS 46606
|
| Min. Negotiated Rate |
$45.37 |
| Max. Negotiated Rate |
$283.50 |
| Rate for Payer: Aetna Commercial |
$93.53
|
| Rate for Payer: Aetna Medicare |
$69.80
|
| Rate for Payer: BCBS Complete |
$47.64
|
| Rate for Payer: BCBS MAPPO |
$69.80
|
| Rate for Payer: BCN Commercial |
$113.54
|
| Rate for Payer: BCN Medicare Advantage |
$69.80
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cofinity Commercial |
$93.53
|
| Rate for Payer: Cofinity Commercial |
$100.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.80
|
| Rate for Payer: Healthscope Commercial |
$83.76
|
| Rate for Payer: Healthscope Whirlpool |
$83.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.29
|
| Rate for Payer: Meridian Medicaid |
$47.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.78
|
| Rate for Payer: Nomi Health Commercial |
$83.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$283.50
|
| Rate for Payer: PACE SWMI |
$69.80
|
| Rate for Payer: PHP Medicare Advantage |
$69.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$138.34
|
| Rate for Payer: Priority Health Medicare |
$69.80
|
| Rate for Payer: Priority Health Narrow Network |
$138.34
|
| Rate for Payer: Railroad Medicare Medicare |
$69.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$69.80
|
| Rate for Payer: UHC Exchange |
$132.08
|
| Rate for Payer: UHC Medicaid |
$45.37
|
| Rate for Payer: UHCCP DNSP |
$69.80
|
| Rate for Payer: UHCCP Medicaid |
$45.37
|
|
|
PR ANOSCOPY W/DILATION
|
Professional
|
Both
|
$1,036.00
|
|
|
Service Code
|
HCPCS 46604
|
| Min. Negotiated Rate |
$39.83 |
| Max. Negotiated Rate |
$777.00 |
| Rate for Payer: Aetna Commercial |
$82.05
|
| Rate for Payer: Aetna Medicare |
$61.23
|
| Rate for Payer: BCBS Complete |
$41.82
|
| Rate for Payer: BCBS MAPPO |
$61.23
|
| Rate for Payer: BCN Commercial |
$98.60
|
| Rate for Payer: BCN Medicare Advantage |
$61.23
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cofinity Commercial |
$88.17
|
| Rate for Payer: Cofinity Commercial |
$82.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.23
|
| Rate for Payer: Healthscope Commercial |
$73.48
|
| Rate for Payer: Healthscope Whirlpool |
$73.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.29
|
| Rate for Payer: Meridian Medicaid |
$41.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.35
|
| Rate for Payer: Nomi Health Commercial |
$73.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$777.00
|
| Rate for Payer: PACE SWMI |
$61.23
|
| Rate for Payer: PHP Medicare Advantage |
$61.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$120.15
|
| Rate for Payer: Priority Health Medicare |
$61.23
|
| Rate for Payer: Priority Health Narrow Network |
$120.15
|
| Rate for Payer: Railroad Medicare Medicare |
$61.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$114.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$61.23
|
| Rate for Payer: UHC Exchange |
$114.89
|
| Rate for Payer: UHC Medicaid |
$39.83
|
| Rate for Payer: UHCCP DNSP |
$61.23
|
| Rate for Payer: UHCCP Medicaid |
$39.83
|
|
|
PR ANOSCOPY W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$367.00
|
|
|
Service Code
|
HCPCS 46608
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$275.25 |
| Rate for Payer: Aetna Commercial |
$108.03
|
| Rate for Payer: Aetna Medicare |
$80.62
|
| Rate for Payer: BCBS Complete |
$54.57
|
| Rate for Payer: BCBS MAPPO |
$80.62
|
| Rate for Payer: BCN Commercial |
$127.49
|
| Rate for Payer: BCN Medicare Advantage |
$80.62
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cash Price |
$293.60
|
| Rate for Payer: Cofinity Commercial |
$116.09
|
| Rate for Payer: Cofinity Commercial |
$108.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.62
|
| Rate for Payer: Healthscope Commercial |
$96.74
|
| Rate for Payer: Healthscope Whirlpool |
$96.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.65
|
| Rate for Payer: Meridian Medicaid |
$54.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.68
|
| Rate for Payer: Nomi Health Commercial |
$96.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$275.25
|
| Rate for Payer: PACE SWMI |
$80.62
|
| Rate for Payer: PHP Medicare Advantage |
$80.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$155.34
|
| Rate for Payer: Priority Health Medicare |
$80.62
|
| Rate for Payer: Priority Health Narrow Network |
$155.34
|
| Rate for Payer: Railroad Medicare Medicare |
$80.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$148.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.62
|
| Rate for Payer: UHC Exchange |
$148.82
|
| Rate for Payer: UHC Medicaid |
$51.97
|
| Rate for Payer: UHCCP DNSP |
$80.62
|
| Rate for Payer: UHCCP Medicaid |
$51.97
|
|
|
PR ANOSCOPY W/RMVL LESION CAUTERY
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
HCPCS 46610
|
| Min. Negotiated Rate |
$48.56 |
| Max. Negotiated Rate |
$443.25 |
| Rate for Payer: Aetna Commercial |
$100.26
|
| Rate for Payer: Aetna Medicare |
$74.82
|
| Rate for Payer: BCBS Complete |
$50.99
|
| Rate for Payer: BCBS MAPPO |
$74.82
|
| Rate for Payer: BCN Commercial |
$120.51
|
| Rate for Payer: BCN Medicare Advantage |
$74.82
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cofinity Commercial |
$107.74
|
| Rate for Payer: Cofinity Commercial |
$100.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.82
|
| Rate for Payer: Healthscope Commercial |
$89.78
|
| Rate for Payer: Healthscope Whirlpool |
$89.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.56
|
| Rate for Payer: Meridian Medicaid |
$50.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.30
|
| Rate for Payer: Nomi Health Commercial |
$89.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$443.25
|
| Rate for Payer: PACE SWMI |
$74.82
|
| Rate for Payer: PHP Medicare Advantage |
$74.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$146.84
|
| Rate for Payer: Priority Health Medicare |
$74.82
|
| Rate for Payer: Priority Health Narrow Network |
$146.84
|
| Rate for Payer: Railroad Medicare Medicare |
$74.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$142.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$74.82
|
| Rate for Payer: UHC Exchange |
$142.61
|
| Rate for Payer: UHC Medicaid |
$48.56
|
| Rate for Payer: UHCCP DNSP |
$74.82
|
| Rate for Payer: UHCCP Medicaid |
$48.56
|
|
|
PR ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
HCPCS 46611
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$443.25 |
| Rate for Payer: Aetna Commercial |
$98.41
|
| Rate for Payer: Aetna Medicare |
$73.44
|
| Rate for Payer: BCBS Complete |
$50.10
|
| Rate for Payer: BCBS MAPPO |
$73.44
|
| Rate for Payer: BCN Commercial |
$120.51
|
| Rate for Payer: BCN Medicare Advantage |
$73.44
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cofinity Commercial |
$98.41
|
| Rate for Payer: Cofinity Commercial |
$105.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$88.13
|
| Rate for Payer: Healthscope Whirlpool |
$88.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.11
|
| Rate for Payer: Meridian Medicaid |
$50.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.78
|
| Rate for Payer: Nomi Health Commercial |
$88.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$443.25
|
| Rate for Payer: PACE SWMI |
$73.44
|
| Rate for Payer: PHP Medicare Advantage |
$73.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$146.84
|
| Rate for Payer: Priority Health Medicare |
$73.44
|
| Rate for Payer: Priority Health Narrow Network |
$146.84
|
| Rate for Payer: Railroad Medicare Medicare |
$73.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$73.44
|
| Rate for Payer: UHC Exchange |
$140.66
|
| Rate for Payer: UHC Medicaid |
$47.71
|
| Rate for Payer: UHCCP DNSP |
$73.44
|
| Rate for Payer: UHCCP Medicaid |
$47.71
|
|
