|
PR EXPL PO HEMRRG THROMBOSIS/INFCTJ CH
|
Professional
|
Both
|
$5,481.00
|
|
|
Service Code
|
HCPCS 35820
|
| Min. Negotiated Rate |
$1,168.60 |
| Max. Negotiated Rate |
$3,836.70 |
| Rate for Payer: Aetna Commercial |
$2,654.31
|
| Rate for Payer: Aetna Medicare |
$1,980.83
|
| Rate for Payer: BCBS Complete |
$1,324.23
|
| Rate for Payer: BCBS MAPPO |
$1,980.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,168.60
|
| Rate for Payer: BCN Commercial |
$2,883.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,980.83
|
| Rate for Payer: Cash Price |
$4,384.80
|
| Rate for Payer: Cash Price |
$4,384.80
|
| Rate for Payer: Cofinity Commercial |
$2,654.31
|
| Rate for Payer: Cofinity Commercial |
$2,852.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,980.83
|
| Rate for Payer: Healthscope Commercial |
$2,377.00
|
| Rate for Payer: Healthscope Whirlpool |
$2,377.00
|
| Rate for Payer: Meridian Medicaid |
$1,324.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,079.87
|
| Rate for Payer: PACE SWMI |
$1,980.83
|
| Rate for Payer: PHP Medicare Advantage |
$1,980.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,261.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,836.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,139.08
|
| Rate for Payer: Priority Health Medicare |
$1,980.83
|
| Rate for Payer: Priority Health Narrow Network |
$3,139.08
|
| Rate for Payer: UHC Medicare Advantage |
$2,040.25
|
|
|
PR EXPL PO HEMRRG THROMBOSIS/INFCTJ NCK
|
Professional
|
Both
|
$1,483.00
|
|
|
Service Code
|
HCPCS 35800
|
| Min. Negotiated Rate |
$465.62 |
| Max. Negotiated Rate |
$1,156.48 |
| Rate for Payer: Aetna Commercial |
$965.20
|
| Rate for Payer: Aetna Medicare |
$720.30
|
| Rate for Payer: BCBS Complete |
$488.90
|
| Rate for Payer: BCBS MAPPO |
$720.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,058.18
|
| Rate for Payer: BCN Commercial |
$1,062.38
|
| Rate for Payer: BCN Medicare Advantage |
$720.30
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cofinity Commercial |
$965.20
|
| Rate for Payer: Cofinity Commercial |
$1,037.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$720.30
|
| Rate for Payer: Healthscope Commercial |
$864.36
|
| Rate for Payer: Healthscope Whirlpool |
$864.36
|
| Rate for Payer: Meridian Medicaid |
$488.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$756.32
|
| Rate for Payer: PACE SWMI |
$720.30
|
| Rate for Payer: PHP Medicare Advantage |
$720.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,156.48
|
| Rate for Payer: Priority Health Medicare |
$720.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,156.48
|
| Rate for Payer: UHC Medicare Advantage |
$741.91
|
|
|
PR EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR
|
Professional
|
Both
|
$1,494.00
|
|
|
Service Code
|
HCPCS 35860
|
| Min. Negotiated Rate |
$528.24 |
| Max. Negotiated Rate |
$1,310.74 |
| Rate for Payer: Aetna Commercial |
$1,108.27
|
| Rate for Payer: Aetna Medicare |
$827.07
|
| Rate for Payer: BCBS Complete |
$554.65
|
| Rate for Payer: BCBS MAPPO |
$827.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,072.45
|
| Rate for Payer: BCN Commercial |
$1,204.10
|
| Rate for Payer: BCN Medicare Advantage |
$827.07
|
| Rate for Payer: Cash Price |
$1,195.20
|
| Rate for Payer: Cash Price |
$1,195.20
|
| Rate for Payer: Cofinity Commercial |
$1,190.98
|
| Rate for Payer: Cofinity Commercial |
$1,108.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$827.07
|
| Rate for Payer: Healthscope Commercial |
$992.48
|
| Rate for Payer: Healthscope Whirlpool |
$992.48
|
| Rate for Payer: Meridian Medicaid |
$554.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$868.42
|
| Rate for Payer: PACE SWMI |
$827.07
|
| Rate for Payer: PHP Medicare Advantage |
$827.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$528.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,045.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,310.74
|
| Rate for Payer: Priority Health Medicare |
$827.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,310.74
|
| Rate for Payer: UHC Medicare Advantage |
$851.88
|
|
|
PR EXPL RETROPERITONEUM W/WO BX SPX
|
Professional
|
Both
|
$1,992.00
|
|
|
Service Code
|
HCPCS 49010
|
| Min. Negotiated Rate |
$588.09 |
| Max. Negotiated Rate |
$1,612.82 |
| Rate for Payer: Aetna Commercial |
$1,227.27
|
| Rate for Payer: Aetna Medicare |
$915.87
|
| Rate for Payer: BCBS Complete |
$617.49
|
| Rate for Payer: BCBS MAPPO |
$915.87
|
| Rate for Payer: BCBS Trust/PPO |
$588.53
|
| Rate for Payer: BCN Commercial |
$1,340.45
|
| Rate for Payer: BCN Medicare Advantage |
$915.87
|
| Rate for Payer: Cash Price |
$1,593.60
|
| Rate for Payer: Cash Price |
$1,593.60
|
| Rate for Payer: Cofinity Commercial |
$1,318.85
|
| Rate for Payer: Cofinity Commercial |
$1,227.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$915.87
|
| Rate for Payer: Healthscope Commercial |
$1,099.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,099.04
|
| Rate for Payer: Meridian Medicaid |
$617.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$961.66
|
| Rate for Payer: PACE SWMI |
$915.87
|
| Rate for Payer: PHP Medicare Advantage |
$915.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$588.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,394.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,612.82
|
| Rate for Payer: Priority Health Medicare |
$915.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,612.82
|
| Rate for Payer: UHC Medicare Advantage |
$943.35
|
|
|
PR EXPL RPR & PRESACRAL DRG RECTAL INJURY
|
Professional
|
Both
|
$3,018.00
|
|
|
Service Code
|
HCPCS 45562
|
| Min. Negotiated Rate |
$748.06 |
| Max. Negotiated Rate |
$2,112.60 |
| Rate for Payer: Aetna Commercial |
$1,499.58
|
| Rate for Payer: Aetna Medicare |
$1,119.09
|
| Rate for Payer: BCBS Complete |
$785.46
|
| Rate for Payer: BCBS MAPPO |
$1,119.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,130.03
|
| Rate for Payer: BCN Commercial |
$1,652.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,119.09
|
| Rate for Payer: Cash Price |
$2,414.40
|
| Rate for Payer: Cash Price |
$2,414.40
|
| Rate for Payer: Cofinity Commercial |
$1,611.49
|
| Rate for Payer: Cofinity Commercial |
$1,499.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,119.09
|
| Rate for Payer: Healthscope Commercial |
$1,342.91
|
| Rate for Payer: Healthscope Whirlpool |
$1,342.91
|
| Rate for Payer: Meridian Medicaid |
$785.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,175.04
|
| Rate for Payer: PACE SWMI |
$1,119.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,119.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$748.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,112.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,988.53
|
| Rate for Payer: Priority Health Medicare |
$1,119.09
|
| Rate for Payer: Priority Health Narrow Network |
$1,988.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,152.66
|
|
|
PR EXPL UNDESCENDED TESTIS W/ABDOMINAL EXPL
|
Professional
|
Both
|
$1,274.00
|
|
|
Service Code
|
HCPCS 54560
|
| Min. Negotiated Rate |
$438.14 |
| Max. Negotiated Rate |
$3,980.21 |
| Rate for Payer: Aetna Commercial |
$900.35
|
| Rate for Payer: Aetna Medicare |
$671.90
|
| Rate for Payer: BCBS Complete |
$460.05
|
| Rate for Payer: BCBS MAPPO |
$671.90
|
| Rate for Payer: BCBS Trust/PPO |
$3,980.21
|
| Rate for Payer: BCN Commercial |
$993.00
|
| Rate for Payer: BCN Medicare Advantage |
$671.90
|
| Rate for Payer: Cash Price |
$1,019.20
|
| Rate for Payer: Cash Price |
$1,019.20
|
| Rate for Payer: Cofinity Commercial |
$967.54
|
| Rate for Payer: Cofinity Commercial |
$900.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$671.90
|
| Rate for Payer: Healthscope Commercial |
$806.28
|
| Rate for Payer: Healthscope Whirlpool |
$806.28
|
| Rate for Payer: Meridian Medicaid |
$460.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$705.50
|
| Rate for Payer: PACE SWMI |
$671.90
|
| Rate for Payer: PHP Medicare Advantage |
$671.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$438.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$891.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,098.01
|
| Rate for Payer: Priority Health Medicare |
$671.90
|
| Rate for Payer: Priority Health Narrow Network |
$1,098.01
|
| Rate for Payer: UHC Medicare Advantage |
$692.06
|
|
|
PR EXPL UNDESCENDED TSTIS INGUN/SCROTAL AREA
|
Professional
|
Both
|
$910.00
|
|
|
Service Code
|
HCPCS 54550
|
| Min. Negotiated Rate |
$314.60 |
| Max. Negotiated Rate |
$2,742.41 |
| Rate for Payer: Aetna Commercial |
$643.37
|
| Rate for Payer: Aetna Medicare |
$480.13
|
| Rate for Payer: BCBS Complete |
$330.33
|
| Rate for Payer: BCBS MAPPO |
$480.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,742.41
|
| Rate for Payer: BCN Commercial |
$711.03
|
| Rate for Payer: BCN Medicare Advantage |
$480.13
|
| Rate for Payer: Cash Price |
$728.00
|
| Rate for Payer: Cash Price |
$728.00
|
| Rate for Payer: Cofinity Commercial |
$691.39
|
| Rate for Payer: Cofinity Commercial |
$643.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.13
|
| Rate for Payer: Healthscope Commercial |
$576.16
|
| Rate for Payer: Healthscope Whirlpool |
$576.16
|
| Rate for Payer: Meridian Medicaid |
$330.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$504.14
|
| Rate for Payer: PACE SWMI |
$480.13
|
| Rate for Payer: PHP Medicare Advantage |
$480.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$314.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$637.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$786.22
|
| Rate for Payer: Priority Health Medicare |
$480.13
|
| Rate for Payer: Priority Health Narrow Network |
$786.22
|
| Rate for Payer: UHC Medicare Advantage |
$494.53
|
|
|
PR EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST
|
Professional
|
Both
|
$804.00
|
|
|
Service Code
|
HCPCS 25248
|
| Min. Negotiated Rate |
$277.33 |
| Max. Negotiated Rate |
$1,918.26 |
| Rate for Payer: Aetna Commercial |
$550.63
|
| Rate for Payer: Aetna Medicare |
$410.92
|
| Rate for Payer: BCBS Complete |
$291.20
|
| Rate for Payer: BCBS MAPPO |
$410.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,918.26
|
| Rate for Payer: BCN Commercial |
$615.74
|
| Rate for Payer: BCN Medicare Advantage |
$410.92
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cash Price |
$643.20
|
| Rate for Payer: Cofinity Commercial |
$591.72
|
| Rate for Payer: Cofinity Commercial |
$550.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.92
|
| Rate for Payer: Healthscope Commercial |
$493.10
|
| Rate for Payer: Healthscope Whirlpool |
$493.10
|
| Rate for Payer: Meridian Medicaid |
$291.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$431.47
|
| Rate for Payer: PACE SWMI |
$410.92
|
| Rate for Payer: PHP Medicare Advantage |
$410.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$643.42
|
| Rate for Payer: Priority Health Medicare |
$410.92
|
| Rate for Payer: Priority Health Narrow Network |
$643.42
|
| Rate for Payer: UHC Medicare Advantage |
$423.25
|
|
|
PR EXPOS PROSTATE ANY APPROACH INSJ RADIOACT SUBST
|
Professional
|
Both
|
$1,640.00
|
|
|
Service Code
|
HCPCS 55860
|
| Min. Negotiated Rate |
$555.29 |
| Max. Negotiated Rate |
$2,253.73 |
| Rate for Payer: Aetna Commercial |
$1,145.53
|
| Rate for Payer: Aetna Medicare |
$854.87
|
| Rate for Payer: BCBS Complete |
$583.05
|
| Rate for Payer: BCBS MAPPO |
$854.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,253.73
|
| Rate for Payer: BCN Commercial |
$1,260.78
|
| Rate for Payer: BCN Medicare Advantage |
$854.87
|
| Rate for Payer: Cash Price |
$1,312.00
|
| Rate for Payer: Cash Price |
$1,312.00
|
| Rate for Payer: Cofinity Commercial |
$1,145.53
|
| Rate for Payer: Cofinity Commercial |
$1,231.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$854.87
|
| Rate for Payer: Healthscope Commercial |
$1,025.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,025.84
|
| Rate for Payer: Meridian Medicaid |
$583.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$897.61
|
| Rate for Payer: PACE SWMI |
$854.87
|
| Rate for Payer: PHP Medicare Advantage |
$854.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$555.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,148.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,394.12
|
| Rate for Payer: Priority Health Medicare |
$854.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,394.12
|
| Rate for Payer: UHC Medicare Advantage |
$880.52
|
|
|
PR EXPRESS FACIAL REFINEMENT OR RELAXATION
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 00126
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
|
|
PR EXT ECG > 48HR TO 21 DAY RCRD W/CONECT INTL RCRD
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 0296T
|
| Min. Negotiated Rate |
$74.00 |
| Max. Negotiated Rate |
$129.50 |
| Rate for Payer: BCBS Complete |
$74.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.50
|
|
|
PR EXT ECG > 48HR TO 21 DAY REVIEW AND INTERPRETATN
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS 0298T
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
|
|
PR EXTENDED ABDOMINOPLASTY
|
Professional
|
Both
|
$5,200.00
|
|
|
Service Code
|
HCPCS 00366
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$2,080.00 |
| Max. Negotiated Rate |
$3,640.00 |
| Rate for Payer: BCBS Complete |
$2,080.00
|
| Rate for Payer: Cash Price |
$4,160.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,640.00
|
|
|
PR EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS
|
Professional
|
Both
|
$284.00
|
|
|
Service Code
|
HCPCS 59412
|
| Min. Negotiated Rate |
$95.21 |
| Max. Negotiated Rate |
$279.47 |
| Rate for Payer: Aetna Commercial |
$137.73
|
| Rate for Payer: Aetna Medicare |
$102.78
|
| Rate for Payer: BCBS Complete |
$99.97
|
| Rate for Payer: BCBS MAPPO |
$102.78
|
| Rate for Payer: BCBS Trust/PPO |
$279.47
|
| Rate for Payer: BCN Commercial |
$150.03
|
| Rate for Payer: BCN Medicare Advantage |
$102.78
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cofinity Commercial |
$137.73
|
| Rate for Payer: Cofinity Commercial |
$148.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.78
|
| Rate for Payer: Healthscope Commercial |
$123.34
|
| Rate for Payer: Healthscope Whirlpool |
$123.34
|
| Rate for Payer: Meridian Medicaid |
$99.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$107.92
|
| Rate for Payer: PACE SWMI |
$102.78
|
| Rate for Payer: PHP Medicare Advantage |
$102.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.95
|
| Rate for Payer: Priority Health Medicare |
$102.78
|
| Rate for Payer: Priority Health Narrow Network |
$144.95
|
| Rate for Payer: UHC Medicare Advantage |
$105.86
|
|
|
PR EXTERNAL DRAINAGE PSEUDOCYST OF PANCREAS OPEN
|
Professional
|
Both
|
$3,021.00
|
|
|
Service Code
|
HCPCS 48510
|
| Min. Negotiated Rate |
$250.41 |
| Max. Negotiated Rate |
$2,114.70 |
| Rate for Payer: Aetna Commercial |
$1,460.68
|
| Rate for Payer: Aetna Medicare |
$1,090.06
|
| Rate for Payer: BCBS Complete |
$737.59
|
| Rate for Payer: BCBS MAPPO |
$1,090.06
|
| Rate for Payer: BCBS Trust/PPO |
$250.41
|
| Rate for Payer: BCN Commercial |
$1,605.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,090.06
|
| Rate for Payer: Cash Price |
$2,416.80
|
| Rate for Payer: Cash Price |
$2,416.80
|
| Rate for Payer: Cofinity Commercial |
$1,569.69
|
| Rate for Payer: Cofinity Commercial |
$1,460.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,090.06
|
| Rate for Payer: Healthscope Commercial |
$1,308.07
|
| Rate for Payer: Healthscope Whirlpool |
$1,308.07
|
| Rate for Payer: Meridian Medicaid |
$737.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,144.56
|
| Rate for Payer: PACE SWMI |
$1,090.06
|
| Rate for Payer: PHP Medicare Advantage |
$1,090.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$702.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,114.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,931.48
|
| Rate for Payer: Priority Health Medicare |
$1,090.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,931.48
|
| Rate for Payer: UHC Medicare Advantage |
$1,122.76
|
|
|
PR EXTERNAL ECG REC>48HR<7D RECORDING
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS 93242
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$526.19 |
| Rate for Payer: Aetna Commercial |
$14.97
|
| Rate for Payer: Aetna Medicare |
$11.17
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$11.17
|
| Rate for Payer: BCBS Trust/PPO |
$526.19
|
| Rate for Payer: BCN Commercial |
$14.13
|
| Rate for Payer: BCN Medicare Advantage |
$11.17
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$14.97
|
| Rate for Payer: Cofinity Commercial |
$16.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.17
|
| Rate for Payer: Healthscope Commercial |
$13.40
|
| Rate for Payer: Healthscope Whirlpool |
$13.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.73
|
| Rate for Payer: PACE SWMI |
$11.17
|
| Rate for Payer: PHP Medicare Advantage |
$11.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.02
|
| Rate for Payer: Priority Health Medicare |
$11.17
|
| Rate for Payer: Priority Health Narrow Network |
$17.02
|
| Rate for Payer: UHC Medicare Advantage |
$11.51
|
|
|
PR EXTERNAL ECG REC>48HR<7D REVIEW & INTERPRETATION
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 93244
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$533.05 |
| Rate for Payer: Aetna Commercial |
$30.71
|
| Rate for Payer: Aetna Medicare |
$22.92
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$22.92
|
| Rate for Payer: BCBS Trust/PPO |
$533.05
|
| Rate for Payer: BCN Commercial |
$27.09
|
| Rate for Payer: BCN Medicare Advantage |
$22.92
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$30.71
|
| Rate for Payer: Cofinity Commercial |
$33.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.92
|
| Rate for Payer: Healthscope Commercial |
$27.50
|
| Rate for Payer: Healthscope Whirlpool |
$27.50
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.07
|
| Rate for Payer: PACE SWMI |
$22.92
|
| Rate for Payer: PHP Medicare Advantage |
$22.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.62
|
| Rate for Payer: Priority Health Medicare |
$22.92
|
| Rate for Payer: Priority Health Narrow Network |
$32.62
|
| Rate for Payer: UHC Medicare Advantage |
$23.61
|
|
|
PR EXTERNAL ECG REC>48HR<7D SCAN ALYS REPORT R&I
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 93241
|
| Min. Negotiated Rate |
$122.40 |
| Max. Negotiated Rate |
$485.51 |
| Rate for Payer: Aetna Commercial |
$328.72
|
| Rate for Payer: Aetna Medicare |
$245.31
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: BCBS MAPPO |
$245.31
|
| Rate for Payer: BCBS Trust/PPO |
$485.51
|
| Rate for Payer: BCN Commercial |
$309.81
|
| Rate for Payer: BCN Medicare Advantage |
$245.31
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$353.25
|
| Rate for Payer: Cofinity Commercial |
$328.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$245.31
|
| Rate for Payer: Healthscope Commercial |
$294.37
|
| Rate for Payer: Healthscope Whirlpool |
$294.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$257.58
|
| Rate for Payer: PACE SWMI |
$245.31
|
| Rate for Payer: PHP Medicare Advantage |
$245.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$373.09
|
| Rate for Payer: Priority Health Medicare |
$245.31
|
| Rate for Payer: Priority Health Narrow Network |
$373.09
|
| Rate for Payer: UHC Medicare Advantage |
$252.67
|
|
|
PR EXTERNAL ECG REC>7D<15D RECORDING
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS 93246
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$607.55 |
| Rate for Payer: Aetna Commercial |
$14.97
|
| Rate for Payer: Aetna Medicare |
$11.17
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$11.17
|
| Rate for Payer: BCBS Trust/PPO |
$607.55
|
| Rate for Payer: BCN Commercial |
$14.13
|
| Rate for Payer: BCN Medicare Advantage |
$11.17
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$14.97
|
| Rate for Payer: Cofinity Commercial |
$16.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.17
|
| Rate for Payer: Healthscope Commercial |
$13.40
|
| Rate for Payer: Healthscope Whirlpool |
$13.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.73
|
| Rate for Payer: PACE SWMI |
$11.17
|
| Rate for Payer: PHP Medicare Advantage |
$11.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.02
|
| Rate for Payer: Priority Health Medicare |
$11.17
|
| Rate for Payer: Priority Health Narrow Network |
$17.02
|
| Rate for Payer: UHC Medicare Advantage |
$11.51
|
|
|
PR EXTERNAL ECG REC>7D<15D REVIEW & INTERPRETATION
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 93248
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$892.83 |
| Rate for Payer: Aetna Commercial |
$33.81
|
| Rate for Payer: Aetna Medicare |
$25.23
|
| Rate for Payer: BCBS Complete |
$16.78
|
| Rate for Payer: BCBS MAPPO |
$25.23
|
| Rate for Payer: BCBS Trust/PPO |
$892.83
|
| Rate for Payer: BCN Commercial |
$29.84
|
| Rate for Payer: BCN Medicare Advantage |
$25.23
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$33.81
|
| Rate for Payer: Cofinity Commercial |
$36.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.23
|
| Rate for Payer: Healthscope Commercial |
$30.28
|
| Rate for Payer: Healthscope Whirlpool |
$30.28
|
| Rate for Payer: Meridian Medicaid |
$16.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.49
|
| Rate for Payer: PACE SWMI |
$25.23
|
| Rate for Payer: PHP Medicare Advantage |
$25.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.93
|
| Rate for Payer: Priority Health Medicare |
$25.23
|
| Rate for Payer: Priority Health Narrow Network |
$35.93
|
| Rate for Payer: UHC Medicare Advantage |
$25.99
|
|
|
PR EXTRAPLEURAL ENUCLEATION EMPYEMA EMPYEMECTOMY
|
Professional
|
Both
|
$3,153.00
|
|
|
Service Code
|
HCPCS 32540
|
| Min. Negotiated Rate |
$1,088.00 |
| Max. Negotiated Rate |
$2,481.51 |
| Rate for Payer: Aetna Commercial |
$2,276.27
|
| Rate for Payer: Aetna Medicare |
$1,698.71
|
| Rate for Payer: BCBS Complete |
$1,142.40
|
| Rate for Payer: BCBS MAPPO |
$1,698.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,336.07
|
| Rate for Payer: BCN Commercial |
$2,481.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,698.71
|
| Rate for Payer: Cash Price |
$2,522.40
|
| Rate for Payer: Cash Price |
$2,522.40
|
| Rate for Payer: Cofinity Commercial |
$2,276.27
|
| Rate for Payer: Cofinity Commercial |
$2,446.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,698.71
|
| Rate for Payer: Healthscope Commercial |
$2,038.45
|
| Rate for Payer: Healthscope Whirlpool |
$2,038.45
|
| Rate for Payer: Meridian Medicaid |
$1,142.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,783.65
|
| Rate for Payer: PACE SWMI |
$1,698.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,698.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,088.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,207.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,351.34
|
| Rate for Payer: Priority Health Medicare |
$1,698.71
|
| Rate for Payer: Priority Health Narrow Network |
$2,351.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,749.67
|
|
|
PR EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5CM/>
|
Professional
|
Both
|
$1,180.00
|
|
|
Service Code
|
HCPCS 26111
|
| Min. Negotiated Rate |
$210.98 |
| Max. Negotiated Rate |
$826.00 |
| Rate for Payer: Aetna Commercial |
$549.12
|
| Rate for Payer: Aetna Medicare |
$409.79
|
| Rate for Payer: BCBS Complete |
$284.26
|
| Rate for Payer: BCBS MAPPO |
$409.79
|
| Rate for Payer: BCBS Trust/PPO |
$210.98
|
| Rate for Payer: BCN Commercial |
$613.77
|
| Rate for Payer: BCN Medicare Advantage |
$409.79
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cash Price |
$944.00
|
| Rate for Payer: Cofinity Commercial |
$549.12
|
| Rate for Payer: Cofinity Commercial |
$590.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$409.79
|
| Rate for Payer: Healthscope Commercial |
$491.75
|
| Rate for Payer: Healthscope Whirlpool |
$491.75
|
| Rate for Payer: Meridian Medicaid |
$284.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$430.28
|
| Rate for Payer: PACE SWMI |
$409.79
|
| Rate for Payer: PHP Medicare Advantage |
$409.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$270.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$641.37
|
| Rate for Payer: Priority Health Medicare |
$409.79
|
| Rate for Payer: Priority Health Narrow Network |
$641.37
|
| Rate for Payer: UHC Medicare Advantage |
$422.08
|
|
|
PR EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5CM/>
|
Professional
|
Both
|
$1,803.00
|
|
|
Service Code
|
HCPCS 26113
|
| Min. Negotiated Rate |
$254.28 |
| Max. Negotiated Rate |
$1,262.10 |
| Rate for Payer: Aetna Commercial |
$722.43
|
| Rate for Payer: Aetna Medicare |
$539.13
|
| Rate for Payer: BCBS Complete |
$373.72
|
| Rate for Payer: BCBS MAPPO |
$539.13
|
| Rate for Payer: BCBS Trust/PPO |
$254.28
|
| Rate for Payer: BCN Commercial |
$807.78
|
| Rate for Payer: BCN Medicare Advantage |
$539.13
|
| Rate for Payer: Cash Price |
$1,442.40
|
| Rate for Payer: Cash Price |
$1,442.40
|
| Rate for Payer: Cofinity Commercial |
$776.35
|
| Rate for Payer: Cofinity Commercial |
$722.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$539.13
|
| Rate for Payer: Healthscope Commercial |
$646.96
|
| Rate for Payer: Healthscope Whirlpool |
$646.96
|
| Rate for Payer: Meridian Medicaid |
$373.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$566.09
|
| Rate for Payer: PACE SWMI |
$539.13
|
| Rate for Payer: PHP Medicare Advantage |
$539.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$355.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$844.11
|
| Rate for Payer: Priority Health Medicare |
$539.13
|
| Rate for Payer: Priority Health Narrow Network |
$844.11
|
| Rate for Payer: UHC Medicare Advantage |
$555.30
|
|
|
PR FAA PHYSICAL
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 00180
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$52.00 |
| Max. Negotiated Rate |
$91.00 |
| Rate for Payer: BCBS Complete |
$52.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.00
|
|
|
PR FACIAL NERVE FUNCTION STUDIES
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 92516
|
| Min. Negotiated Rate |
$22.51 |
| Max. Negotiated Rate |
$2,145.40 |
| Rate for Payer: Aetna Commercial |
$30.16
|
| Rate for Payer: Aetna Medicare |
$22.51
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS MAPPO |
$22.51
|
| Rate for Payer: BCBS Trust/PPO |
$2,145.40
|
| Rate for Payer: BCN Commercial |
$103.60
|
| Rate for Payer: BCN Medicare Advantage |
$22.51
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$30.16
|
| Rate for Payer: Cofinity Commercial |
$32.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.51
|
| Rate for Payer: Healthscope Commercial |
$27.01
|
| Rate for Payer: Healthscope Whirlpool |
$27.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.64
|
| Rate for Payer: PACE SWMI |
$22.51
|
| Rate for Payer: PHP Medicare Advantage |
$22.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.54
|
| Rate for Payer: Priority Health Medicare |
$22.51
|
| Rate for Payer: Priority Health Narrow Network |
$30.54
|
| Rate for Payer: UHC Medicare Advantage |
$23.19
|
|
