|
PR I&D SOFT TISSUE ABSCESS SUBFASCIAL
|
Professional
|
Both
|
$505.00
|
|
|
Service Code
|
HCPCS 20005
|
| Min. Negotiated Rate |
$202.00 |
| Max. Negotiated Rate |
$353.50 |
| Rate for Payer: BCBS Complete |
$202.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.50
|
|
|
PR I&D SUBMUCOSAL ABSCESS RECTUM
|
Professional
|
Both
|
$517.00
|
|
|
Service Code
|
HCPCS 45005
|
| Min. Negotiated Rate |
$106.50 |
| Max. Negotiated Rate |
$2,676.37 |
| Rate for Payer: Aetna Commercial |
$219.24
|
| Rate for Payer: Aetna Medicare |
$163.61
|
| Rate for Payer: BCBS Complete |
$111.82
|
| Rate for Payer: BCBS MAPPO |
$163.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,676.37
|
| Rate for Payer: BCN Commercial |
$468.15
|
| Rate for Payer: BCN Medicare Advantage |
$163.61
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cash Price |
$413.60
|
| Rate for Payer: Cofinity Commercial |
$235.60
|
| Rate for Payer: Cofinity Commercial |
$219.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.61
|
| Rate for Payer: Healthscope Commercial |
$196.33
|
| Rate for Payer: Healthscope Whirlpool |
$196.33
|
| Rate for Payer: Meridian Medicaid |
$111.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.79
|
| Rate for Payer: PACE SWMI |
$163.61
|
| Rate for Payer: PHP Medicare Advantage |
$163.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$294.57
|
| Rate for Payer: Priority Health Medicare |
$163.61
|
| Rate for Payer: Priority Health Narrow Network |
$294.57
|
| Rate for Payer: UHC Medicare Advantage |
$168.52
|
|
|
PR I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$608.00
|
|
|
Service Code
|
HCPCS 23930
|
| Min. Negotiated Rate |
$18.25 |
| Max. Negotiated Rate |
$531.68 |
| Rate for Payer: Aetna Commercial |
$284.94
|
| Rate for Payer: Aetna Medicare |
$212.64
|
| Rate for Payer: BCBS Complete |
$146.04
|
| Rate for Payer: BCBS MAPPO |
$212.64
|
| Rate for Payer: BCBS Trust/PPO |
$18.25
|
| Rate for Payer: BCN Commercial |
$531.68
|
| Rate for Payer: BCN Medicare Advantage |
$212.64
|
| Rate for Payer: Cash Price |
$486.40
|
| Rate for Payer: Cash Price |
$486.40
|
| Rate for Payer: Cofinity Commercial |
$284.94
|
| Rate for Payer: Cofinity Commercial |
$306.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$212.64
|
| Rate for Payer: Healthscope Commercial |
$255.17
|
| Rate for Payer: Healthscope Whirlpool |
$255.17
|
| Rate for Payer: Meridian Medicaid |
$146.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$223.27
|
| Rate for Payer: PACE SWMI |
$212.64
|
| Rate for Payer: PHP Medicare Advantage |
$212.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$425.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$330.90
|
| Rate for Payer: Priority Health Medicare |
$212.64
|
| Rate for Payer: Priority Health Narrow Network |
$330.90
|
| Rate for Payer: UHC Medicare Advantage |
$219.02
|
|
|
PR I&D VAGINAL HEMATOMA NON-OBSTETRICAL
|
Professional
|
Both
|
$516.00
|
|
|
Service Code
|
HCPCS 57023
|
| Min. Negotiated Rate |
$205.97 |
| Max. Negotiated Rate |
$2,321.35 |
| Rate for Payer: Aetna Commercial |
$424.85
|
| Rate for Payer: Aetna Medicare |
$317.05
|
| Rate for Payer: BCBS Complete |
$216.27
|
| Rate for Payer: BCBS MAPPO |
$317.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,321.35
|
| Rate for Payer: BCN Commercial |
$469.62
|
| Rate for Payer: BCN Medicare Advantage |
$317.05
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cash Price |
$412.80
|
| Rate for Payer: Cofinity Commercial |
$424.85
|
| Rate for Payer: Cofinity Commercial |
$456.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$317.05
|
| Rate for Payer: Healthscope Commercial |
$380.46
|
| Rate for Payer: Healthscope Whirlpool |
$380.46
|
| Rate for Payer: Meridian Medicaid |
$216.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$332.90
|
| Rate for Payer: PACE SWMI |
$317.05
|
| Rate for Payer: PHP Medicare Advantage |
$317.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$361.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$454.97
|
| Rate for Payer: Priority Health Medicare |
$317.05
|
| Rate for Payer: Priority Health Narrow Network |
$454.97
|
| Rate for Payer: UHC Medicare Advantage |
$326.56
|
|
|
PR I&D VAGINAL HEMATOMA OBSTETRICAL/POSTPARTUM
|
Professional
|
Both
|
$449.00
|
|
|
Service Code
|
HCPCS 57022
|
| Min. Negotiated Rate |
$116.72 |
| Max. Negotiated Rate |
$3,001.80 |
| Rate for Payer: Aetna Commercial |
$240.20
|
| Rate for Payer: Aetna Medicare |
$179.25
|
| Rate for Payer: BCBS Complete |
$122.56
|
| Rate for Payer: BCBS MAPPO |
$179.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,001.80
|
| Rate for Payer: BCN Commercial |
$266.82
|
| Rate for Payer: BCN Medicare Advantage |
$179.25
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cofinity Commercial |
$258.12
|
| Rate for Payer: Cofinity Commercial |
$240.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.25
|
| Rate for Payer: Healthscope Commercial |
$215.10
|
| Rate for Payer: Healthscope Whirlpool |
$215.10
|
| Rate for Payer: Meridian Medicaid |
$122.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$188.21
|
| Rate for Payer: PACE SWMI |
$179.25
|
| Rate for Payer: PHP Medicare Advantage |
$179.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$314.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$258.48
|
| Rate for Payer: Priority Health Medicare |
$179.25
|
| Rate for Payer: Priority Health Narrow Network |
$258.48
|
| Rate for Payer: UHC Medicare Advantage |
$184.63
|
|
|
PR I&D VULVA/PERINEAL ABSCESS
|
Professional
|
Both
|
$273.00
|
|
|
Service Code
|
HCPCS 56405
|
| Min. Negotiated Rate |
$82.01 |
| Max. Negotiated Rate |
$1,505.13 |
| Rate for Payer: Aetna Commercial |
$166.33
|
| Rate for Payer: Aetna Medicare |
$124.13
|
| Rate for Payer: BCBS Complete |
$86.11
|
| Rate for Payer: BCBS MAPPO |
$124.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,505.13
|
| Rate for Payer: BCN Commercial |
$217.95
|
| Rate for Payer: BCN Medicare Advantage |
$124.13
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cofinity Commercial |
$166.33
|
| Rate for Payer: Cofinity Commercial |
$178.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.13
|
| Rate for Payer: Healthscope Commercial |
$148.96
|
| Rate for Payer: Healthscope Whirlpool |
$148.96
|
| Rate for Payer: Meridian Medicaid |
$86.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$130.34
|
| Rate for Payer: PACE SWMI |
$124.13
|
| Rate for Payer: PHP Medicare Advantage |
$124.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.32
|
| Rate for Payer: Priority Health Medicare |
$124.13
|
| Rate for Payer: Priority Health Narrow Network |
$181.32
|
| Rate for Payer: UHC Medicare Advantage |
$127.85
|
|
|
PR IIV3 VACCINE SPLIT VIRUS 0.25 ML DOSAGE IM USE
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS 90657
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$17.00 |
| Rate for Payer: Aetna Commercial |
$9.50
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS Trust/PPO |
$17.00
|
| Rate for Payer: BCN Commercial |
$17.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.00
|
|
|
PR IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS 90658
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$17.00 |
| Rate for Payer: Aetna Commercial |
$16.32
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS Trust/PPO |
$17.00
|
| Rate for Payer: BCN Commercial |
$17.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.00
|
|
|
PR IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 90656
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$17.69 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS Trust/PPO |
$17.00
|
| Rate for Payer: BCN Commercial |
$17.00
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
|
|
PR IIV3 VACC PRESRV FREE 0.25 ML DOSAGE IM USE
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 90655
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$17.00 |
| Rate for Payer: Aetna Commercial |
$16.30
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS Trust/PPO |
$17.00
|
| Rate for Payer: BCN Commercial |
$17.00
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.10
|
|
|
PR IIV4 VACC PRESRV FREE 0.5 ML DOS FOR IM USE
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS 90686
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$30.99 |
| Rate for Payer: Aetna Commercial |
$28.83
|
| Rate for Payer: Aetna Medicare |
$21.52
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: BCBS MAPPO |
$21.52
|
| Rate for Payer: BCBS Trust/PPO |
$22.65
|
| Rate for Payer: BCN Commercial |
$22.65
|
| Rate for Payer: BCN Medicare Advantage |
$21.52
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$28.83
|
| Rate for Payer: Cofinity Commercial |
$30.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.52
|
| Rate for Payer: Healthscope Commercial |
$25.82
|
| Rate for Payer: Healthscope Whirlpool |
$25.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.59
|
| Rate for Payer: PACE SWMI |
$21.52
|
| Rate for Payer: PHP Medicare Advantage |
$21.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health Medicare |
$21.52
|
| Rate for Payer: UHC Medicare Advantage |
$22.16
|
|
|
PR IIV4 VACC PRSRV FREE 0.25 ML DOS FOR IM USE
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS 90685
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$22.05 |
| Rate for Payer: Aetna Commercial |
$19.36
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: BCBS Trust/PPO |
$22.05
|
| Rate for Payer: BCN Commercial |
$22.05
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
|
|
PR IIV4 VACC SPLIT VIRUS 0.25 ML DOS FOR IM USE
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS 90687
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$17.50 |
| Rate for Payer: Aetna Commercial |
$13.72
|
| Rate for Payer: Aetna Medicare |
$10.24
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: BCBS MAPPO |
$10.24
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Commercial |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$10.24
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$13.72
|
| Rate for Payer: Cofinity Commercial |
$14.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.24
|
| Rate for Payer: Healthscope Commercial |
$12.29
|
| Rate for Payer: Healthscope Whirlpool |
$12.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.75
|
| Rate for Payer: PACE SWMI |
$10.24
|
| Rate for Payer: PHP Medicare Advantage |
$10.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health Medicare |
$10.24
|
| Rate for Payer: UHC Medicare Advantage |
$10.55
|
|
|
PR IIV4 VACC SPLIT VIRUS 0.5 ML DOS FOR IM USE
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS 90688
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$29.49 |
| Rate for Payer: Aetna Commercial |
$27.45
|
| Rate for Payer: Aetna Medicare |
$20.48
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: BCBS MAPPO |
$20.48
|
| Rate for Payer: BCBS Trust/PPO |
$21.56
|
| Rate for Payer: BCN Commercial |
$21.56
|
| Rate for Payer: BCN Medicare Advantage |
$20.48
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$29.49
|
| Rate for Payer: Cofinity Commercial |
$27.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.48
|
| Rate for Payer: Healthscope Commercial |
$24.58
|
| Rate for Payer: Healthscope Whirlpool |
$24.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.51
|
| Rate for Payer: PACE SWMI |
$20.48
|
| Rate for Payer: PHP Medicare Advantage |
$20.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health Medicare |
$20.48
|
| Rate for Payer: UHC Medicare Advantage |
$21.10
|
|
|
PR IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS 90662
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$100.72 |
| Rate for Payer: Aetna Commercial |
$93.72
|
| Rate for Payer: Aetna Medicare |
$69.94
|
| Rate for Payer: BCBS Complete |
$27.20
|
| Rate for Payer: BCBS MAPPO |
$69.94
|
| Rate for Payer: BCBS Trust/PPO |
$73.62
|
| Rate for Payer: BCN Commercial |
$73.62
|
| Rate for Payer: BCN Medicare Advantage |
$69.94
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$100.72
|
| Rate for Payer: Cofinity Commercial |
$93.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.94
|
| Rate for Payer: Healthscope Commercial |
$83.93
|
| Rate for Payer: Healthscope Whirlpool |
$83.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$73.44
|
| Rate for Payer: PACE SWMI |
$69.94
|
| Rate for Payer: PHP Medicare Advantage |
$69.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.60
|
| Rate for Payer: Priority Health Medicare |
$69.94
|
| Rate for Payer: UHC Medicare Advantage |
$72.04
|
|
|
PR ILEOSCOPY STOMA W/BALLOON DILATION
|
Professional
|
Both
|
$230.00
|
|
|
Service Code
|
HCPCS 44381
|
| Min. Negotiated Rate |
$53.68 |
| Max. Negotiated Rate |
$1,457.24 |
| Rate for Payer: Aetna Commercial |
$110.42
|
| Rate for Payer: Aetna Medicare |
$82.40
|
| Rate for Payer: BCBS Complete |
$56.36
|
| Rate for Payer: BCBS MAPPO |
$82.40
|
| Rate for Payer: BCBS Trust/PPO |
$282.11
|
| Rate for Payer: BCN Commercial |
$1,457.24
|
| Rate for Payer: BCN Medicare Advantage |
$82.40
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cash Price |
$184.00
|
| Rate for Payer: Cofinity Commercial |
$110.42
|
| Rate for Payer: Cofinity Commercial |
$118.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.40
|
| Rate for Payer: Healthscope Commercial |
$98.88
|
| Rate for Payer: Healthscope Whirlpool |
$98.88
|
| Rate for Payer: Meridian Medicaid |
$56.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$86.52
|
| Rate for Payer: PACE SWMI |
$82.40
|
| Rate for Payer: PHP Medicare Advantage |
$82.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$147.00
|
| Rate for Payer: Priority Health Medicare |
$82.40
|
| Rate for Payer: Priority Health Narrow Network |
$147.00
|
| Rate for Payer: UHC Medicare Advantage |
$84.87
|
|
|
PR ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$919.00
|
|
|
Service Code
|
HCPCS 44382
|
| Min. Negotiated Rate |
$46.86 |
| Max. Negotiated Rate |
$643.30 |
| Rate for Payer: Aetna Commercial |
$96.60
|
| Rate for Payer: Aetna Medicare |
$72.09
|
| Rate for Payer: BCBS Complete |
$49.20
|
| Rate for Payer: BCBS MAPPO |
$72.09
|
| Rate for Payer: BCBS Trust/PPO |
$226.11
|
| Rate for Payer: BCN Commercial |
$440.79
|
| Rate for Payer: BCN Medicare Advantage |
$72.09
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cash Price |
$735.20
|
| Rate for Payer: Cofinity Commercial |
$103.81
|
| Rate for Payer: Cofinity Commercial |
$96.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.09
|
| Rate for Payer: Healthscope Commercial |
$86.51
|
| Rate for Payer: Healthscope Whirlpool |
$86.51
|
| Rate for Payer: Meridian Medicaid |
$49.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.69
|
| Rate for Payer: PACE SWMI |
$72.09
|
| Rate for Payer: PHP Medicare Advantage |
$72.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$643.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.76
|
| Rate for Payer: Priority Health Medicare |
$72.09
|
| Rate for Payer: Priority Health Narrow Network |
$128.76
|
| Rate for Payer: UHC Medicare Advantage |
$74.25
|
|
|
PR ILEOSCOPY STOMA W/PLMT OF ENDOSCOPIC STENT
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 44384
|
| Min. Negotiated Rate |
$95.85 |
| Max. Negotiated Rate |
$402.56 |
| Rate for Payer: Aetna Commercial |
$202.43
|
| Rate for Payer: Aetna Medicare |
$151.07
|
| Rate for Payer: BCBS Complete |
$100.64
|
| Rate for Payer: BCBS MAPPO |
$151.07
|
| Rate for Payer: BCBS Trust/PPO |
$402.56
|
| Rate for Payer: BCN Commercial |
$222.35
|
| Rate for Payer: BCN Medicare Advantage |
$151.07
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$217.54
|
| Rate for Payer: Cofinity Commercial |
$202.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.07
|
| Rate for Payer: Healthscope Commercial |
$181.28
|
| Rate for Payer: Healthscope Whirlpool |
$181.28
|
| Rate for Payer: Meridian Medicaid |
$100.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$158.62
|
| Rate for Payer: PACE SWMI |
$151.07
|
| Rate for Payer: PHP Medicare Advantage |
$151.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$267.53
|
| Rate for Payer: Priority Health Medicare |
$151.07
|
| Rate for Payer: Priority Health Narrow Network |
$267.53
|
| Rate for Payer: UHC Medicare Advantage |
$155.60
|
|
|
PR ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD
|
Professional
|
Both
|
$822.00
|
|
|
Service Code
|
HCPCS 44380
|
| Min. Negotiated Rate |
$36.42 |
| Max. Negotiated Rate |
$575.40 |
| Rate for Payer: Aetna Commercial |
$73.83
|
| Rate for Payer: Aetna Medicare |
$55.10
|
| Rate for Payer: BCBS Complete |
$38.24
|
| Rate for Payer: BCBS MAPPO |
$55.10
|
| Rate for Payer: BCBS Trust/PPO |
$247.77
|
| Rate for Payer: BCN Commercial |
$287.83
|
| Rate for Payer: BCN Medicare Advantage |
$55.10
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cofinity Commercial |
$79.34
|
| Rate for Payer: Cofinity Commercial |
$73.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.10
|
| Rate for Payer: Healthscope Commercial |
$66.12
|
| Rate for Payer: Healthscope Whirlpool |
$66.12
|
| Rate for Payer: Meridian Medicaid |
$38.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.86
|
| Rate for Payer: PACE SWMI |
$55.10
|
| Rate for Payer: PHP Medicare Advantage |
$55.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.78
|
| Rate for Payer: Priority Health Medicare |
$55.10
|
| Rate for Payer: Priority Health Narrow Network |
$98.78
|
| Rate for Payer: UHC Medicare Advantage |
$56.75
|
|
|
PR ILEOSCOPY,THRU STOMA,TRANSENDO STENT
|
Professional
|
Both
|
$1,066.00
|
|
|
Service Code
|
HCPCS 44383
|
| Min. Negotiated Rate |
$426.40 |
| Max. Negotiated Rate |
$746.20 |
| Rate for Payer: BCBS Complete |
$426.40
|
| Rate for Payer: Cash Price |
$852.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$746.20
|
|
|
PR ILEOSTOMY/JEJUNOSTOMY NON-TUBE
|
Professional
|
Both
|
$2,504.00
|
|
|
Service Code
|
HCPCS 44310
|
| Min. Negotiated Rate |
$81.93 |
| Max. Negotiated Rate |
$1,819.78 |
| Rate for Payer: Aetna Commercial |
$1,379.29
|
| Rate for Payer: Aetna Medicare |
$1,029.32
|
| Rate for Payer: BCBS Complete |
$695.55
|
| Rate for Payer: BCBS MAPPO |
$1,029.32
|
| Rate for Payer: BCBS Trust/PPO |
$81.93
|
| Rate for Payer: BCN Commercial |
$1,512.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,029.32
|
| Rate for Payer: Cash Price |
$2,003.20
|
| Rate for Payer: Cash Price |
$2,003.20
|
| Rate for Payer: Cofinity Commercial |
$1,482.22
|
| Rate for Payer: Cofinity Commercial |
$1,379.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,029.32
|
| Rate for Payer: Healthscope Commercial |
$1,235.18
|
| Rate for Payer: Healthscope Whirlpool |
$1,235.18
|
| Rate for Payer: Meridian Medicaid |
$695.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,080.79
|
| Rate for Payer: PACE SWMI |
$1,029.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,029.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$662.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,752.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,819.78
|
| Rate for Payer: Priority Health Medicare |
$1,029.32
|
| Rate for Payer: Priority Health Narrow Network |
$1,819.78
|
| Rate for Payer: UHC Medicare Advantage |
$1,060.20
|
|
|
PR ILIAC ART ANGIO,CARDIAC CATH
|
Professional
|
Both
|
$35.00
|
|
|
Service Code
|
HCPCS G0278
|
| Min. Negotiated Rate |
$13.44 |
| Max. Negotiated Rate |
$152.15 |
| Rate for Payer: Aetna Commercial |
$18.01
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: BCBS Complete |
$14.00
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCBS Trust/PPO |
$152.15
|
| Rate for Payer: BCN Commercial |
$19.55
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cofinity Commercial |
$19.35
|
| Rate for Payer: Cofinity Commercial |
$18.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$16.13
|
| Rate for Payer: Healthscope Whirlpool |
$16.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.11
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.48
|
| Rate for Payer: Priority Health Medicare |
$13.44
|
| Rate for Payer: Priority Health Narrow Network |
$20.48
|
| Rate for Payer: UHC Medicare Advantage |
$13.84
|
|
|
PR IM ADM INTRANSL/ORAL 1 VACCINE
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 90473
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$611.77 |
| Rate for Payer: Aetna Commercial |
$21.04
|
| Rate for Payer: Aetna Medicare |
$15.70
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$15.70
|
| Rate for Payer: BCBS Trust/PPO |
$611.77
|
| Rate for Payer: BCN Commercial |
$19.24
|
| Rate for Payer: BCN Medicare Advantage |
$15.70
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$21.04
|
| Rate for Payer: Cofinity Commercial |
$22.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.70
|
| Rate for Payer: Healthscope Commercial |
$18.84
|
| Rate for Payer: Healthscope Whirlpool |
$18.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.48
|
| Rate for Payer: PACE SWMI |
$15.70
|
| Rate for Payer: PHP Medicare Advantage |
$15.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.75
|
| Rate for Payer: Priority Health Medicare |
$15.70
|
| Rate for Payer: Priority Health Narrow Network |
$26.75
|
| Rate for Payer: UHC Medicare Advantage |
$16.17
|
|
|
PR IM ADM INTRANSL/ORAL EA VACCINE
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 90474
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$652.45 |
| Rate for Payer: Aetna Commercial |
$15.16
|
| Rate for Payer: Aetna Medicare |
$11.31
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$11.31
|
| Rate for Payer: BCBS Trust/PPO |
$652.45
|
| Rate for Payer: BCN Commercial |
$13.75
|
| Rate for Payer: BCN Medicare Advantage |
$11.31
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$15.16
|
| Rate for Payer: Cofinity Commercial |
$16.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.31
|
| Rate for Payer: Healthscope Commercial |
$13.57
|
| Rate for Payer: Healthscope Whirlpool |
$13.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.88
|
| Rate for Payer: PACE SWMI |
$11.31
|
| Rate for Payer: PHP Medicare Advantage |
$11.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.72
|
| Rate for Payer: Priority Health Medicare |
$11.31
|
| Rate for Payer: Priority Health Narrow Network |
$15.72
|
| Rate for Payer: UHC Medicare Advantage |
$11.65
|
|
|
PR IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 90471
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$593.28 |
| Rate for Payer: Aetna Commercial |
$25.58
|
| Rate for Payer: Aetna Medicare |
$19.09
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$19.09
|
| Rate for Payer: BCBS Trust/PPO |
$593.28
|
| Rate for Payer: BCN Commercial |
$26.78
|
| Rate for Payer: BCN Medicare Advantage |
$19.09
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$27.49
|
| Rate for Payer: Cofinity Commercial |
$25.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.09
|
| Rate for Payer: Healthscope Commercial |
$22.91
|
| Rate for Payer: Healthscope Whirlpool |
$22.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20.04
|
| Rate for Payer: PACE SWMI |
$19.09
|
| Rate for Payer: PHP Medicare Advantage |
$19.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.75
|
| Rate for Payer: Priority Health Medicare |
$19.09
|
| Rate for Payer: Priority Health Narrow Network |
$26.75
|
| Rate for Payer: UHC Medicare Advantage |
$19.66
|
|
