|
PR BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX
|
Professional
|
Both
|
$266.00
|
|
|
Service Code
|
HCPCS 57500
|
| Min. Negotiated Rate |
$43.67 |
| Max. Negotiated Rate |
$199.50 |
| Rate for Payer: Aetna Commercial |
$90.36
|
| Rate for Payer: Aetna Medicare |
$67.43
|
| Rate for Payer: BCBS Complete |
$45.85
|
| Rate for Payer: BCBS MAPPO |
$67.43
|
| Rate for Payer: BCN Commercial |
$89.14
|
| Rate for Payer: BCN Medicare Advantage |
$67.43
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cofinity Commercial |
$90.36
|
| Rate for Payer: Cofinity Commercial |
$97.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.43
|
| Rate for Payer: Healthscope Commercial |
$80.92
|
| Rate for Payer: Healthscope Whirlpool |
$80.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.80
|
| Rate for Payer: Meridian Medicaid |
$45.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.17
|
| Rate for Payer: Nomi Health Commercial |
$80.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.50
|
| Rate for Payer: PACE SWMI |
$67.43
|
| Rate for Payer: PHP Medicare Advantage |
$67.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$114.49
|
| Rate for Payer: Priority Health Medicare |
$67.43
|
| Rate for Payer: Priority Health Narrow Network |
$114.49
|
| Rate for Payer: Railroad Medicare Medicare |
$67.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$132.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$67.43
|
| Rate for Payer: UHC Exchange |
$132.08
|
| Rate for Payer: UHC Medicaid |
$43.67
|
| Rate for Payer: UHCCP DNSP |
$67.43
|
| Rate for Payer: UHCCP Medicaid |
$43.67
|
|
|
PR BIOPSY, EACH ADDED LESION
|
Professional
|
Both
|
$70.00
|
|
|
Service Code
|
HCPCS 11101
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: BCBS Complete |
$28.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.50
|
|
|
PR BIOPSY EXTERNAL AUDITORY CANAL
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 69105
|
| Min. Negotiated Rate |
$36.64 |
| Max. Negotiated Rate |
$184.50 |
| Rate for Payer: Aetna Commercial |
$74.58
|
| Rate for Payer: Aetna Medicare |
$55.66
|
| Rate for Payer: BCBS Complete |
$38.47
|
| Rate for Payer: BCBS MAPPO |
$55.66
|
| Rate for Payer: BCN Commercial |
$97.60
|
| Rate for Payer: BCN Medicare Advantage |
$55.66
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cofinity Commercial |
$80.15
|
| Rate for Payer: Cofinity Commercial |
$74.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.66
|
| Rate for Payer: Healthscope Commercial |
$66.79
|
| Rate for Payer: Healthscope Whirlpool |
$66.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.44
|
| Rate for Payer: Meridian Medicaid |
$38.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.23
|
| Rate for Payer: Nomi Health Commercial |
$66.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.50
|
| Rate for Payer: PACE SWMI |
$55.66
|
| Rate for Payer: PHP Medicare Advantage |
$55.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$96.44
|
| Rate for Payer: Priority Health Medicare |
$55.66
|
| Rate for Payer: Priority Health Narrow Network |
$96.44
|
| Rate for Payer: Railroad Medicare Medicare |
$55.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55.66
|
| Rate for Payer: UHC Exchange |
$107.39
|
| Rate for Payer: UHC Medicaid |
$36.64
|
| Rate for Payer: UHCCP DNSP |
$55.66
|
| Rate for Payer: UHCCP Medicaid |
$36.64
|
|
|
PR BIOPSY EXTERNAL EAR
|
Professional
|
Both
|
$179.00
|
|
|
Service Code
|
HCPCS 69100
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$134.25 |
| Rate for Payer: Aetna Commercial |
$49.53
|
| Rate for Payer: Aetna Medicare |
$36.96
|
| Rate for Payer: BCBS Complete |
$25.05
|
| Rate for Payer: BCBS MAPPO |
$36.96
|
| Rate for Payer: BCN Commercial |
$68.72
|
| Rate for Payer: BCN Medicare Advantage |
$36.96
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cofinity Commercial |
$53.22
|
| Rate for Payer: Cofinity Commercial |
$49.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.96
|
| Rate for Payer: Healthscope Commercial |
$44.35
|
| Rate for Payer: Healthscope Whirlpool |
$44.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.81
|
| Rate for Payer: Meridian Medicaid |
$25.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.66
|
| Rate for Payer: Nomi Health Commercial |
$44.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$134.25
|
| Rate for Payer: PACE SWMI |
$36.96
|
| Rate for Payer: PHP Medicare Advantage |
$36.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$67.91
|
| Rate for Payer: Priority Health Medicare |
$36.96
|
| Rate for Payer: Priority Health Narrow Network |
$67.91
|
| Rate for Payer: Railroad Medicare Medicare |
$36.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.96
|
| Rate for Payer: UHC Exchange |
$83.52
|
| Rate for Payer: UHC Medicaid |
$23.86
|
| Rate for Payer: UHCCP DNSP |
$36.96
|
| Rate for Payer: UHCCP Medicaid |
$23.86
|
|
|
PR BIOPSY FLOOR MOUTH
|
Professional
|
Both
|
$247.00
|
|
|
Service Code
|
HCPCS 41108
|
| Min. Negotiated Rate |
$53.68 |
| Max. Negotiated Rate |
$185.25 |
| Rate for Payer: Aetna Commercial |
$108.59
|
| Rate for Payer: Aetna Medicare |
$81.04
|
| Rate for Payer: BCBS Complete |
$56.36
|
| Rate for Payer: BCBS MAPPO |
$81.04
|
| Rate for Payer: BCN Commercial |
$138.94
|
| Rate for Payer: BCN Medicare Advantage |
$81.04
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cofinity Commercial |
$108.59
|
| Rate for Payer: Cofinity Commercial |
$116.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.04
|
| Rate for Payer: Healthscope Commercial |
$97.25
|
| Rate for Payer: Healthscope Whirlpool |
$97.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.09
|
| Rate for Payer: Meridian Medicaid |
$56.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$89.14
|
| Rate for Payer: Nomi Health Commercial |
$97.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.25
|
| Rate for Payer: PACE SWMI |
$81.04
|
| Rate for Payer: PHP Medicare Advantage |
$81.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$169.29
|
| Rate for Payer: Priority Health Medicare |
$81.04
|
| Rate for Payer: Priority Health Narrow Network |
$169.29
|
| Rate for Payer: Railroad Medicare Medicare |
$81.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$151.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$81.04
|
| Rate for Payer: UHC Exchange |
$151.35
|
| Rate for Payer: UHC Medicaid |
$53.68
|
| Rate for Payer: UHCCP DNSP |
$81.04
|
| Rate for Payer: UHCCP Medicaid |
$53.68
|
|
|
PR BIOPSY HYPOPHARYNX
|
Professional
|
Both
|
$454.00
|
|
|
Service Code
|
HCPCS 42802
|
| Min. Negotiated Rate |
$181.60 |
| Max. Negotiated Rate |
$340.50 |
| Rate for Payer: BCBS Complete |
$181.60
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$340.50
|
|
|
PR BIOPSY INTRANASAL
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 30100
|
| Min. Negotiated Rate |
$38.98 |
| Max. Negotiated Rate |
$176.25 |
| Rate for Payer: Aetna Commercial |
$79.62
|
| Rate for Payer: Aetna Medicare |
$59.42
|
| Rate for Payer: BCBS Complete |
$40.93
|
| Rate for Payer: BCBS MAPPO |
$59.42
|
| Rate for Payer: BCN Commercial |
$103.58
|
| Rate for Payer: BCN Medicare Advantage |
$59.42
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$85.56
|
| Rate for Payer: Cofinity Commercial |
$79.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.42
|
| Rate for Payer: Healthscope Commercial |
$71.30
|
| Rate for Payer: Healthscope Whirlpool |
$71.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.39
|
| Rate for Payer: Meridian Medicaid |
$40.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.36
|
| Rate for Payer: Nomi Health Commercial |
$71.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$176.25
|
| Rate for Payer: PACE SWMI |
$59.42
|
| Rate for Payer: PHP Medicare Advantage |
$59.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$97.54
|
| Rate for Payer: Priority Health Medicare |
$59.42
|
| Rate for Payer: Priority Health Narrow Network |
$97.54
|
| Rate for Payer: Railroad Medicare Medicare |
$59.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$115.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.42
|
| Rate for Payer: UHC Exchange |
$115.40
|
| Rate for Payer: UHC Medicaid |
$38.98
|
| Rate for Payer: UHCCP DNSP |
$59.42
|
| Rate for Payer: UHCCP Medicaid |
$38.98
|
|
|
PR BIOPSY LIVER NEEDLE PERCUTANEOUS
|
Professional
|
Both
|
$611.00
|
|
|
Service Code
|
HCPCS 47000
|
| Min. Negotiated Rate |
$48.78 |
| Max. Negotiated Rate |
$458.25 |
| Rate for Payer: Aetna Commercial |
$101.49
|
| Rate for Payer: Aetna Medicare |
$75.74
|
| Rate for Payer: BCBS Complete |
$51.22
|
| Rate for Payer: BCBS MAPPO |
$75.74
|
| Rate for Payer: BCN Commercial |
$141.69
|
| Rate for Payer: BCN Medicare Advantage |
$75.74
|
| Rate for Payer: Cash Price |
$488.80
|
| Rate for Payer: Cash Price |
$488.80
|
| Rate for Payer: Cofinity Commercial |
$109.07
|
| Rate for Payer: Cofinity Commercial |
$101.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.74
|
| Rate for Payer: Healthscope Commercial |
$90.89
|
| Rate for Payer: Healthscope Whirlpool |
$90.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.53
|
| Rate for Payer: Meridian Medicaid |
$51.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.31
|
| Rate for Payer: Nomi Health Commercial |
$90.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$458.25
|
| Rate for Payer: PACE SWMI |
$75.74
|
| Rate for Payer: PHP Medicare Advantage |
$75.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$157.15
|
| Rate for Payer: Priority Health Medicare |
$75.74
|
| Rate for Payer: Priority Health Narrow Network |
$157.15
|
| Rate for Payer: Railroad Medicare Medicare |
$75.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$156.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.74
|
| Rate for Payer: UHC Exchange |
$156.58
|
| Rate for Payer: UHC Medicaid |
$48.78
|
| Rate for Payer: UHCCP DNSP |
$75.74
|
| Rate for Payer: UHCCP Medicaid |
$48.78
|
|
|
PR BIOPSY LIVER WEDGE
|
Professional
|
Both
|
$1,843.00
|
|
|
Service Code
|
HCPCS 47100
|
| Min. Negotiated Rate |
$519.51 |
| Max. Negotiated Rate |
$1,558.76 |
| Rate for Payer: Aetna Commercial |
$1,076.42
|
| Rate for Payer: Aetna Medicare |
$803.30
|
| Rate for Payer: BCBS Complete |
$545.49
|
| Rate for Payer: BCBS MAPPO |
$803.30
|
| Rate for Payer: BCN Commercial |
$1,279.31
|
| Rate for Payer: BCN Medicare Advantage |
$803.30
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cash Price |
$1,474.40
|
| Rate for Payer: Cofinity Commercial |
$1,076.42
|
| Rate for Payer: Cofinity Commercial |
$1,156.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$803.30
|
| Rate for Payer: Healthscope Commercial |
$963.96
|
| Rate for Payer: Healthscope Whirlpool |
$963.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$843.47
|
| Rate for Payer: Meridian Medicaid |
$545.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$883.63
|
| Rate for Payer: Nomi Health Commercial |
$963.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,382.25
|
| Rate for Payer: PACE SWMI |
$803.30
|
| Rate for Payer: PHP Medicare Advantage |
$803.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$519.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,558.76
|
| Rate for Payer: Priority Health Medicare |
$803.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,558.76
|
| Rate for Payer: Railroad Medicare Medicare |
$803.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,500.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$803.30
|
| Rate for Payer: UHC Exchange |
$1,500.61
|
| Rate for Payer: UHC Medicaid |
$519.51
|
| Rate for Payer: UHCCP DNSP |
$803.30
|
| Rate for Payer: UHCCP Medicaid |
$519.51
|
|
|
PR BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$785.00
|
|
|
Service Code
|
HCPCS 32405
|
| Min. Negotiated Rate |
$314.00 |
| Max. Negotiated Rate |
$588.75 |
| Rate for Payer: BCBS Complete |
$314.00
|
| Rate for Payer: Cash Price |
$628.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$588.75
|
|
|
PR BIOPSY MUSCLE DEEP
|
Professional
|
Both
|
$609.00
|
|
|
Service Code
|
HCPCS 20205
|
| Min. Negotiated Rate |
$93.72 |
| Max. Negotiated Rate |
$456.75 |
| Rate for Payer: Aetna Commercial |
$195.00
|
| Rate for Payer: Aetna Medicare |
$145.52
|
| Rate for Payer: BCBS Complete |
$98.41
|
| Rate for Payer: BCBS MAPPO |
$145.52
|
| Rate for Payer: BCN Commercial |
$233.06
|
| Rate for Payer: BCN Medicare Advantage |
$145.52
|
| Rate for Payer: Cash Price |
$487.20
|
| Rate for Payer: Cash Price |
$487.20
|
| Rate for Payer: Cofinity Commercial |
$209.55
|
| Rate for Payer: Cofinity Commercial |
$195.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.52
|
| Rate for Payer: Healthscope Commercial |
$174.62
|
| Rate for Payer: Healthscope Whirlpool |
$174.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.80
|
| Rate for Payer: Meridian Medicaid |
$98.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$160.07
|
| Rate for Payer: Nomi Health Commercial |
$174.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$456.75
|
| Rate for Payer: PACE SWMI |
$145.52
|
| Rate for Payer: PHP Medicare Advantage |
$145.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$249.13
|
| Rate for Payer: Priority Health Medicare |
$145.52
|
| Rate for Payer: Priority Health Narrow Network |
$249.13
|
| Rate for Payer: Railroad Medicare Medicare |
$145.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$270.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$145.52
|
| Rate for Payer: UHC Exchange |
$270.83
|
| Rate for Payer: UHC Medicaid |
$93.72
|
| Rate for Payer: UHCCP DNSP |
$145.52
|
| Rate for Payer: UHCCP Medicaid |
$93.72
|
|
|
PR BIOPSY MUSCLE PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$426.00
|
|
|
Service Code
|
HCPCS 20206
|
| Min. Negotiated Rate |
$32.59 |
| Max. Negotiated Rate |
$319.50 |
| Rate for Payer: Aetna Commercial |
$67.36
|
| Rate for Payer: Aetna Medicare |
$50.27
|
| Rate for Payer: BCBS Complete |
$34.22
|
| Rate for Payer: BCBS MAPPO |
$50.27
|
| Rate for Payer: BCN Commercial |
$85.15
|
| Rate for Payer: BCN Medicare Advantage |
$50.27
|
| Rate for Payer: Cash Price |
$340.80
|
| Rate for Payer: Cash Price |
$340.80
|
| Rate for Payer: Cofinity Commercial |
$72.39
|
| Rate for Payer: Cofinity Commercial |
$67.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.27
|
| Rate for Payer: Healthscope Commercial |
$60.32
|
| Rate for Payer: Healthscope Whirlpool |
$60.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.78
|
| Rate for Payer: Meridian Medicaid |
$34.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.30
|
| Rate for Payer: Nomi Health Commercial |
$60.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$319.50
|
| Rate for Payer: PACE SWMI |
$50.27
|
| Rate for Payer: PHP Medicare Advantage |
$50.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$91.02
|
| Rate for Payer: Priority Health Medicare |
$50.27
|
| Rate for Payer: Priority Health Narrow Network |
$91.02
|
| Rate for Payer: Railroad Medicare Medicare |
$50.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$50.27
|
| Rate for Payer: UHC Exchange |
$101.72
|
| Rate for Payer: UHC Medicaid |
$32.59
|
| Rate for Payer: UHCCP DNSP |
$50.27
|
| Rate for Payer: UHCCP Medicaid |
$32.59
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Professional
|
Both
|
$370.00
|
|
|
Service Code
|
HCPCS 20200
|
| Min. Negotiated Rate |
$57.51 |
| Max. Negotiated Rate |
$277.50 |
| Rate for Payer: Aetna Commercial |
$119.43
|
| Rate for Payer: Aetna Medicare |
$89.13
|
| Rate for Payer: BCBS Complete |
$60.39
|
| Rate for Payer: BCBS MAPPO |
$89.13
|
| Rate for Payer: BCN Commercial |
$144.41
|
| Rate for Payer: BCN Medicare Advantage |
$89.13
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cofinity Commercial |
$128.35
|
| Rate for Payer: Cofinity Commercial |
$119.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.13
|
| Rate for Payer: Healthscope Commercial |
$106.96
|
| Rate for Payer: Healthscope Whirlpool |
$106.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.59
|
| Rate for Payer: Meridian Medicaid |
$60.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.04
|
| Rate for Payer: Nomi Health Commercial |
$106.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.50
|
| Rate for Payer: PACE SWMI |
$89.13
|
| Rate for Payer: PHP Medicare Advantage |
$89.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$154.37
|
| Rate for Payer: Priority Health Medicare |
$89.13
|
| Rate for Payer: Priority Health Narrow Network |
$154.37
|
| Rate for Payer: Railroad Medicare Medicare |
$89.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$166.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$89.13
|
| Rate for Payer: UHC Exchange |
$166.50
|
| Rate for Payer: UHC Medicaid |
$57.51
|
| Rate for Payer: UHCCP DNSP |
$89.13
|
| Rate for Payer: UHCCP Medicaid |
$57.51
|
|
|
PR BIOPSY NAIL UNIT SEPARATE PROCEDURE
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 11755
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$171.00 |
| Rate for Payer: Aetna Commercial |
$72.43
|
| Rate for Payer: Aetna Medicare |
$54.05
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS MAPPO |
$54.05
|
| Rate for Payer: BCN Commercial |
$71.08
|
| Rate for Payer: BCN Medicare Advantage |
$54.05
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$77.83
|
| Rate for Payer: Cofinity Commercial |
$72.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.05
|
| Rate for Payer: Healthscope Commercial |
$64.86
|
| Rate for Payer: Healthscope Whirlpool |
$64.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.75
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.45
|
| Rate for Payer: Nomi Health Commercial |
$64.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.00
|
| Rate for Payer: PACE SWMI |
$54.05
|
| Rate for Payer: PHP Medicare Advantage |
$54.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$82.50
|
| Rate for Payer: Priority Health Medicare |
$54.05
|
| Rate for Payer: Priority Health Narrow Network |
$82.50
|
| Rate for Payer: Railroad Medicare Medicare |
$54.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$109.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$54.05
|
| Rate for Payer: UHC Exchange |
$109.43
|
| Rate for Payer: UHC Medicaid |
$34.72
|
| Rate for Payer: UHCCP DNSP |
$54.05
|
| Rate for Payer: UHCCP Medicaid |
$34.72
|
|
|
PR BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE
|
Professional
|
Both
|
$863.00
|
|
|
Service Code
|
HCPCS 42804
|
| Min. Negotiated Rate |
$71.99 |
| Max. Negotiated Rate |
$647.25 |
| Rate for Payer: Aetna Commercial |
$144.76
|
| Rate for Payer: Aetna Medicare |
$108.03
|
| Rate for Payer: BCBS Complete |
$75.59
|
| Rate for Payer: BCBS MAPPO |
$108.03
|
| Rate for Payer: BCN Commercial |
$185.75
|
| Rate for Payer: BCN Medicare Advantage |
$108.03
|
| Rate for Payer: Cash Price |
$690.40
|
| Rate for Payer: Cash Price |
$690.40
|
| Rate for Payer: Cofinity Commercial |
$155.56
|
| Rate for Payer: Cofinity Commercial |
$144.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.03
|
| Rate for Payer: Healthscope Commercial |
$129.64
|
| Rate for Payer: Healthscope Whirlpool |
$129.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.43
|
| Rate for Payer: Meridian Medicaid |
$75.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.83
|
| Rate for Payer: Nomi Health Commercial |
$129.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$647.25
|
| Rate for Payer: PACE SWMI |
$108.03
|
| Rate for Payer: PHP Medicare Advantage |
$108.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$226.32
|
| Rate for Payer: Priority Health Medicare |
$108.03
|
| Rate for Payer: Priority Health Narrow Network |
$226.32
|
| Rate for Payer: Railroad Medicare Medicare |
$108.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$108.03
|
| Rate for Payer: UHC Exchange |
$195.72
|
| Rate for Payer: UHC Medicaid |
$71.99
|
| Rate for Payer: UHCCP DNSP |
$108.03
|
| Rate for Payer: UHCCP Medicaid |
$71.99
|
|
|
PR BIOPSY NERVE
|
Professional
|
Both
|
$744.00
|
|
|
Service Code
|
HCPCS 64795
|
| Min. Negotiated Rate |
$118.85 |
| Max. Negotiated Rate |
$558.00 |
| Rate for Payer: Aetna Commercial |
$247.94
|
| Rate for Payer: Aetna Medicare |
$185.03
|
| Rate for Payer: BCBS Complete |
$124.79
|
| Rate for Payer: BCBS MAPPO |
$185.03
|
| Rate for Payer: BCN Commercial |
$297.79
|
| Rate for Payer: BCN Medicare Advantage |
$185.03
|
| Rate for Payer: Cash Price |
$595.20
|
| Rate for Payer: Cash Price |
$595.20
|
| Rate for Payer: Cofinity Commercial |
$266.44
|
| Rate for Payer: Cofinity Commercial |
$247.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.03
|
| Rate for Payer: Healthscope Commercial |
$222.04
|
| Rate for Payer: Healthscope Whirlpool |
$222.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.28
|
| Rate for Payer: Meridian Medicaid |
$124.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$203.53
|
| Rate for Payer: Nomi Health Commercial |
$222.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$558.00
|
| Rate for Payer: PACE SWMI |
$185.03
|
| Rate for Payer: PHP Medicare Advantage |
$185.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$345.88
|
| Rate for Payer: Priority Health Medicare |
$185.03
|
| Rate for Payer: Priority Health Narrow Network |
$345.88
|
| Rate for Payer: Railroad Medicare Medicare |
$185.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$340.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$185.03
|
| Rate for Payer: UHC Exchange |
$340.17
|
| Rate for Payer: UHC Medicaid |
$118.85
|
| Rate for Payer: UHCCP DNSP |
$185.03
|
| Rate for Payer: UHCCP Medicaid |
$118.85
|
|
|
PR BIOPSY OF LIP
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 40490
|
| Min. Negotiated Rate |
$35.78 |
| Max. Negotiated Rate |
$176.25 |
| Rate for Payer: Aetna Commercial |
$74.45
|
| Rate for Payer: Aetna Medicare |
$55.56
|
| Rate for Payer: BCBS Complete |
$37.57
|
| Rate for Payer: BCBS MAPPO |
$55.56
|
| Rate for Payer: BCN Commercial |
$81.68
|
| Rate for Payer: BCN Medicare Advantage |
$55.56
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$74.45
|
| Rate for Payer: Cofinity Commercial |
$80.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.56
|
| Rate for Payer: Healthscope Commercial |
$66.67
|
| Rate for Payer: Healthscope Whirlpool |
$66.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.34
|
| Rate for Payer: Meridian Medicaid |
$37.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.12
|
| Rate for Payer: Nomi Health Commercial |
$66.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$176.25
|
| Rate for Payer: PACE SWMI |
$55.56
|
| Rate for Payer: PHP Medicare Advantage |
$55.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$126.20
|
| Rate for Payer: Priority Health Medicare |
$55.56
|
| Rate for Payer: Priority Health Narrow Network |
$126.20
|
| Rate for Payer: Railroad Medicare Medicare |
$55.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$123.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55.56
|
| Rate for Payer: UHC Exchange |
$123.73
|
| Rate for Payer: UHC Medicaid |
$35.78
|
| Rate for Payer: UHCCP DNSP |
$55.56
|
| Rate for Payer: UHCCP Medicaid |
$35.78
|
|
|
PR BIOPSY OF SKIN LESION
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 11100
|
| Min. Negotiated Rate |
$70.40 |
| Max. Negotiated Rate |
$132.00 |
| Rate for Payer: BCBS Complete |
$70.40
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.00
|
|
|
PR BIOPSY OROPHARYNX
|
Professional
|
Both
|
$266.00
|
|
|
Service Code
|
HCPCS 42800
|
| Min. Negotiated Rate |
$67.73 |
| Max. Negotiated Rate |
$217.22 |
| Rate for Payer: Aetna Commercial |
$137.43
|
| Rate for Payer: Aetna Medicare |
$102.56
|
| Rate for Payer: BCBS Complete |
$71.12
|
| Rate for Payer: BCBS MAPPO |
$102.56
|
| Rate for Payer: BCN Commercial |
$178.28
|
| Rate for Payer: BCN Medicare Advantage |
$102.56
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cofinity Commercial |
$147.69
|
| Rate for Payer: Cofinity Commercial |
$137.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.56
|
| Rate for Payer: Healthscope Commercial |
$123.07
|
| Rate for Payer: Healthscope Whirlpool |
$123.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.69
|
| Rate for Payer: Meridian Medicaid |
$71.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$112.82
|
| Rate for Payer: Nomi Health Commercial |
$123.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.50
|
| Rate for Payer: PACE SWMI |
$102.56
|
| Rate for Payer: PHP Medicare Advantage |
$102.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$217.22
|
| Rate for Payer: Priority Health Medicare |
$102.56
|
| Rate for Payer: Priority Health Narrow Network |
$217.22
|
| Rate for Payer: Railroad Medicare Medicare |
$102.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$193.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$102.56
|
| Rate for Payer: UHC Exchange |
$193.70
|
| Rate for Payer: UHC Medicaid |
$67.73
|
| Rate for Payer: UHCCP DNSP |
$102.56
|
| Rate for Payer: UHCCP Medicaid |
$67.73
|
|
|
PR BIOPSY OVARY UNI/BI SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,666.00
|
|
|
Service Code
|
HCPCS 58900
|
| Min. Negotiated Rate |
$248.15 |
| Max. Negotiated Rate |
$1,249.50 |
| Rate for Payer: Aetna Commercial |
$512.01
|
| Rate for Payer: Aetna Medicare |
$382.10
|
| Rate for Payer: BCBS Complete |
$260.56
|
| Rate for Payer: BCBS MAPPO |
$382.10
|
| Rate for Payer: BCN Commercial |
$656.34
|
| Rate for Payer: BCN Medicare Advantage |
$382.10
|
| Rate for Payer: Cash Price |
$1,332.80
|
| Rate for Payer: Cash Price |
$1,332.80
|
| Rate for Payer: Cofinity Commercial |
$550.22
|
| Rate for Payer: Cofinity Commercial |
$512.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.10
|
| Rate for Payer: Healthscope Commercial |
$458.52
|
| Rate for Payer: Healthscope Whirlpool |
$458.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$401.20
|
| Rate for Payer: Meridian Medicaid |
$260.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$420.31
|
| Rate for Payer: Nomi Health Commercial |
$458.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,249.50
|
| Rate for Payer: PACE SWMI |
$382.10
|
| Rate for Payer: PHP Medicare Advantage |
$382.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$248.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$664.73
|
| Rate for Payer: Priority Health Medicare |
$382.10
|
| Rate for Payer: Priority Health Narrow Network |
$664.73
|
| Rate for Payer: Railroad Medicare Medicare |
$382.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$751.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$382.10
|
| Rate for Payer: UHC Exchange |
$751.99
|
| Rate for Payer: UHC Medicaid |
$248.15
|
| Rate for Payer: UHCCP DNSP |
$382.10
|
| Rate for Payer: UHCCP Medicaid |
$248.15
|
|
|
PR BIOPSY PALATE UVULA
|
Professional
|
Both
|
$276.00
|
|
|
Service Code
|
HCPCS 42100
|
| Min. Negotiated Rate |
$64.75 |
| Max. Negotiated Rate |
$207.00 |
| Rate for Payer: Aetna Commercial |
$131.15
|
| Rate for Payer: Aetna Medicare |
$97.87
|
| Rate for Payer: BCBS Complete |
$67.99
|
| Rate for Payer: BCBS MAPPO |
$97.87
|
| Rate for Payer: BCN Commercial |
$166.82
|
| Rate for Payer: BCN Medicare Advantage |
$97.87
|
| Rate for Payer: Cash Price |
$220.80
|
| Rate for Payer: Cash Price |
$220.80
|
| Rate for Payer: Cofinity Commercial |
$140.93
|
| Rate for Payer: Cofinity Commercial |
$131.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.87
|
| Rate for Payer: Healthscope Commercial |
$117.44
|
| Rate for Payer: Healthscope Whirlpool |
$117.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.76
|
| Rate for Payer: Meridian Medicaid |
$67.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.66
|
| Rate for Payer: Nomi Health Commercial |
$117.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$207.00
|
| Rate for Payer: PACE SWMI |
$97.87
|
| Rate for Payer: PHP Medicare Advantage |
$97.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$203.26
|
| Rate for Payer: Priority Health Medicare |
$97.87
|
| Rate for Payer: Priority Health Narrow Network |
$203.26
|
| Rate for Payer: Railroad Medicare Medicare |
$97.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$185.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.87
|
| Rate for Payer: UHC Exchange |
$185.07
|
| Rate for Payer: UHC Medicaid |
$64.75
|
| Rate for Payer: UHCCP DNSP |
$97.87
|
| Rate for Payer: UHCCP Medicaid |
$64.75
|
|
|
PR BIOPSY PANCREAS OPEN
|
Professional
|
Both
|
$1,636.00
|
|
|
Service Code
|
HCPCS 48100
|
| Min. Negotiated Rate |
$538.25 |
| Max. Negotiated Rate |
$1,628.54 |
| Rate for Payer: Aetna Commercial |
$1,121.94
|
| Rate for Payer: Aetna Medicare |
$837.27
|
| Rate for Payer: BCBS Complete |
$565.16
|
| Rate for Payer: BCBS MAPPO |
$837.27
|
| Rate for Payer: BCN Commercial |
$1,336.58
|
| Rate for Payer: BCN Medicare Advantage |
$837.27
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cash Price |
$1,308.80
|
| Rate for Payer: Cofinity Commercial |
$1,205.67
|
| Rate for Payer: Cofinity Commercial |
$1,121.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$837.27
|
| Rate for Payer: Healthscope Commercial |
$1,004.72
|
| Rate for Payer: Healthscope Whirlpool |
$1,004.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$879.13
|
| Rate for Payer: Meridian Medicaid |
$565.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$921.00
|
| Rate for Payer: Nomi Health Commercial |
$1,004.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,227.00
|
| Rate for Payer: PACE SWMI |
$837.27
|
| Rate for Payer: PHP Medicare Advantage |
$837.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,628.54
|
| Rate for Payer: Priority Health Medicare |
$837.27
|
| Rate for Payer: Priority Health Narrow Network |
$1,628.54
|
| Rate for Payer: Railroad Medicare Medicare |
$837.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,575.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$837.27
|
| Rate for Payer: UHC Exchange |
$1,575.24
|
| Rate for Payer: UHC Medicaid |
$538.25
|
| Rate for Payer: UHCCP DNSP |
$837.27
|
| Rate for Payer: UHCCP Medicaid |
$538.25
|
|
|
PR BIOPSY PENIS DEEP STRUCTURES
|
Professional
|
Both
|
$580.00
|
|
|
Service Code
|
HCPCS 54105
|
| Min. Negotiated Rate |
$124.61 |
| Max. Negotiated Rate |
$435.00 |
| Rate for Payer: Aetna Commercial |
$256.74
|
| Rate for Payer: Aetna Medicare |
$191.60
|
| Rate for Payer: BCBS Complete |
$130.84
|
| Rate for Payer: BCBS MAPPO |
$191.60
|
| Rate for Payer: BCN Commercial |
$320.20
|
| Rate for Payer: BCN Medicare Advantage |
$191.60
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cash Price |
$464.00
|
| Rate for Payer: Cofinity Commercial |
$275.90
|
| Rate for Payer: Cofinity Commercial |
$256.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$191.60
|
| Rate for Payer: Healthscope Commercial |
$229.92
|
| Rate for Payer: Healthscope Whirlpool |
$229.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$201.18
|
| Rate for Payer: Meridian Medicaid |
$130.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$210.76
|
| Rate for Payer: Nomi Health Commercial |
$229.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$435.00
|
| Rate for Payer: PACE SWMI |
$191.60
|
| Rate for Payer: PHP Medicare Advantage |
$191.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$348.81
|
| Rate for Payer: Priority Health Medicare |
$191.60
|
| Rate for Payer: Priority Health Narrow Network |
$348.81
|
| Rate for Payer: Railroad Medicare Medicare |
$191.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$373.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$191.60
|
| Rate for Payer: UHC Exchange |
$373.28
|
| Rate for Payer: UHC Medicaid |
$124.61
|
| Rate for Payer: UHCCP DNSP |
$191.60
|
| Rate for Payer: UHCCP Medicaid |
$124.61
|
|
|
PR BIOPSY PENIS SEPARATE PROCEDURE
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 54100
|
| Min. Negotiated Rate |
$66.24 |
| Max. Negotiated Rate |
$237.00 |
| Rate for Payer: Aetna Commercial |
$136.22
|
| Rate for Payer: Aetna Medicare |
$101.66
|
| Rate for Payer: BCBS Complete |
$69.55
|
| Rate for Payer: BCBS MAPPO |
$101.66
|
| Rate for Payer: BCN Commercial |
$182.76
|
| Rate for Payer: BCN Medicare Advantage |
$101.66
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cofinity Commercial |
$146.39
|
| Rate for Payer: Cofinity Commercial |
$136.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.66
|
| Rate for Payer: Healthscope Commercial |
$121.99
|
| Rate for Payer: Healthscope Whirlpool |
$121.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.74
|
| Rate for Payer: Meridian Medicaid |
$69.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.83
|
| Rate for Payer: Nomi Health Commercial |
$121.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.00
|
| Rate for Payer: PACE SWMI |
$101.66
|
| Rate for Payer: PHP Medicare Advantage |
$101.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$199.08
|
| Rate for Payer: Priority Health Medicare |
$101.66
|
| Rate for Payer: Priority Health Narrow Network |
$199.08
|
| Rate for Payer: Railroad Medicare Medicare |
$101.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$212.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.66
|
| Rate for Payer: UHC Exchange |
$212.25
|
| Rate for Payer: UHC Medicaid |
$66.24
|
| Rate for Payer: UHCCP DNSP |
$101.66
|
| Rate for Payer: UHCCP Medicaid |
$66.24
|
|
|
PR BIOPSY PROSTATE ANY APPROACH NONIMAGING-GUIDED
|
Professional
|
Both
|
$491.00
|
|
|
Service Code
|
HCPCS 55705
|
| Min. Negotiated Rate |
$63.69 |
| Max. Negotiated Rate |
$468.11 |
| Rate for Payer: Aetna Commercial |
$131.72
|
| Rate for Payer: Aetna Medicare |
$98.30
|
| Rate for Payer: BCBS Complete |
$66.87
|
| Rate for Payer: BCBS MAPPO |
$98.30
|
| Rate for Payer: BCN Commercial |
$397.38
|
| Rate for Payer: BCN Medicare Advantage |
$98.30
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Cash Price |
$392.80
|
| Rate for Payer: Cofinity Commercial |
$141.55
|
| Rate for Payer: Cofinity Commercial |
$131.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.30
|
| Rate for Payer: Healthscope Commercial |
$117.96
|
| Rate for Payer: Healthscope Whirlpool |
$117.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.22
|
| Rate for Payer: Meridian Medicaid |
$66.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.13
|
| Rate for Payer: Nomi Health Commercial |
$117.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$368.25
|
| Rate for Payer: PACE SWMI |
$98.30
|
| Rate for Payer: PHP Medicare Advantage |
$98.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$432.89
|
| Rate for Payer: Priority Health Medicare |
$98.30
|
| Rate for Payer: Priority Health Narrow Network |
$432.89
|
| Rate for Payer: Railroad Medicare Medicare |
$98.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$468.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.30
|
| Rate for Payer: UHC Exchange |
$468.11
|
| Rate for Payer: UHC Medicaid |
$63.69
|
| Rate for Payer: UHCCP DNSP |
$98.30
|
| Rate for Payer: UHCCP Medicaid |
$63.69
|
|
