|
PR BIOPSY PROSTATE TRANSRECTAL ULTRASOUND-GUIDED
|
Professional
|
Both
|
$326.00
|
|
|
Service Code
|
HCPCS 55707
|
| Min. Negotiated Rate |
$86.90 |
| Max. Negotiated Rate |
$250.32 |
| Rate for Payer: Aetna Commercial |
$180.35
|
| Rate for Payer: Aetna Medicare |
$134.59
|
| Rate for Payer: BCBS Complete |
$91.25
|
| Rate for Payer: BCBS MAPPO |
$134.59
|
| Rate for Payer: BCN Medicare Advantage |
$134.59
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cofinity Commercial |
$193.81
|
| Rate for Payer: Cofinity Commercial |
$180.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.59
|
| Rate for Payer: Healthscope Commercial |
$161.51
|
| Rate for Payer: Healthscope Whirlpool |
$161.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.32
|
| Rate for Payer: Meridian Medicaid |
$91.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$148.05
|
| Rate for Payer: Nomi Health Commercial |
$161.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$244.50
|
| Rate for Payer: PACE SWMI |
$134.59
|
| Rate for Payer: PHP Medicare Advantage |
$134.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$200.93
|
| Rate for Payer: Priority Health Medicare |
$134.59
|
| Rate for Payer: Priority Health Narrow Network |
$200.93
|
| Rate for Payer: Railroad Medicare Medicare |
$134.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$250.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.59
|
| Rate for Payer: UHC Exchange |
$250.32
|
| Rate for Payer: UHC Medicaid |
$86.90
|
| Rate for Payer: UHCCP DNSP |
$134.59
|
| Rate for Payer: UHCCP Medicaid |
$86.90
|
|
|
PR BIOPSY SALIVARY GLAND INCISIONAL
|
Professional
|
Both
|
$549.00
|
|
|
Service Code
|
HCPCS 42405
|
| Min. Negotiated Rate |
$128.87 |
| Max. Negotiated Rate |
$418.06 |
| Rate for Payer: Aetna Commercial |
$264.37
|
| Rate for Payer: Aetna Medicare |
$197.29
|
| Rate for Payer: BCBS Complete |
$135.31
|
| Rate for Payer: BCBS MAPPO |
$197.29
|
| Rate for Payer: BCN Commercial |
$343.11
|
| Rate for Payer: BCN Medicare Advantage |
$197.29
|
| Rate for Payer: Cash Price |
$439.20
|
| Rate for Payer: Cash Price |
$439.20
|
| Rate for Payer: Cofinity Commercial |
$284.10
|
| Rate for Payer: Cofinity Commercial |
$264.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.29
|
| Rate for Payer: Healthscope Commercial |
$236.75
|
| Rate for Payer: Healthscope Whirlpool |
$236.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.15
|
| Rate for Payer: Meridian Medicaid |
$135.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$217.02
|
| Rate for Payer: Nomi Health Commercial |
$236.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$411.75
|
| Rate for Payer: PACE SWMI |
$197.29
|
| Rate for Payer: PHP Medicare Advantage |
$197.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$418.06
|
| Rate for Payer: Priority Health Medicare |
$197.29
|
| Rate for Payer: Priority Health Narrow Network |
$418.06
|
| Rate for Payer: Railroad Medicare Medicare |
$197.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$392.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$197.29
|
| Rate for Payer: UHC Exchange |
$392.58
|
| Rate for Payer: UHC Medicaid |
$128.87
|
| Rate for Payer: UHCCP DNSP |
$197.29
|
| Rate for Payer: UHCCP Medicaid |
$128.87
|
|
|
PR BIOPSY SOFT TISSUE BACK/FLANK DEEP
|
Professional
|
Both
|
$948.00
|
|
|
Service Code
|
HCPCS 21925
|
| Min. Negotiated Rate |
$237.71 |
| Max. Negotiated Rate |
$711.00 |
| Rate for Payer: Aetna Commercial |
$483.55
|
| Rate for Payer: Aetna Medicare |
$360.86
|
| Rate for Payer: BCBS Complete |
$249.60
|
| Rate for Payer: BCBS MAPPO |
$360.86
|
| Rate for Payer: BCN Commercial |
$578.16
|
| Rate for Payer: BCN Medicare Advantage |
$360.86
|
| Rate for Payer: Cash Price |
$758.40
|
| Rate for Payer: Cash Price |
$758.40
|
| Rate for Payer: Cofinity Commercial |
$519.64
|
| Rate for Payer: Cofinity Commercial |
$483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$360.86
|
| Rate for Payer: Healthscope Commercial |
$433.03
|
| Rate for Payer: Healthscope Whirlpool |
$433.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$378.90
|
| Rate for Payer: Meridian Medicaid |
$249.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$396.95
|
| Rate for Payer: Nomi Health Commercial |
$433.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$711.00
|
| Rate for Payer: PACE SWMI |
$360.86
|
| Rate for Payer: PHP Medicare Advantage |
$360.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$618.03
|
| Rate for Payer: Priority Health Medicare |
$360.86
|
| Rate for Payer: Priority Health Narrow Network |
$618.03
|
| Rate for Payer: Railroad Medicare Medicare |
$360.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$628.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$360.86
|
| Rate for Payer: UHC Exchange |
$628.49
|
| Rate for Payer: UHC Medicaid |
$237.71
|
| Rate for Payer: UHCCP DNSP |
$360.86
|
| Rate for Payer: UHCCP Medicaid |
$237.71
|
|
|
PR BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL
|
Professional
|
Both
|
$523.00
|
|
|
Service Code
|
HCPCS 21920
|
| Min. Negotiated Rate |
$90.74 |
| Max. Negotiated Rate |
$392.25 |
| Rate for Payer: Aetna Commercial |
$185.00
|
| Rate for Payer: Aetna Medicare |
$138.06
|
| Rate for Payer: BCBS Complete |
$95.28
|
| Rate for Payer: BCBS MAPPO |
$138.06
|
| Rate for Payer: BCN Commercial |
$234.05
|
| Rate for Payer: BCN Medicare Advantage |
$138.06
|
| Rate for Payer: Cash Price |
$418.40
|
| Rate for Payer: Cash Price |
$418.40
|
| Rate for Payer: Cofinity Commercial |
$198.81
|
| Rate for Payer: Cofinity Commercial |
$185.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.06
|
| Rate for Payer: Healthscope Commercial |
$165.67
|
| Rate for Payer: Healthscope Whirlpool |
$165.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.96
|
| Rate for Payer: Meridian Medicaid |
$95.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$151.87
|
| Rate for Payer: Nomi Health Commercial |
$165.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$392.25
|
| Rate for Payer: PACE SWMI |
$138.06
|
| Rate for Payer: PHP Medicare Advantage |
$138.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$250.20
|
| Rate for Payer: Priority Health Medicare |
$138.06
|
| Rate for Payer: Priority Health Narrow Network |
$250.20
|
| Rate for Payer: Railroad Medicare Medicare |
$138.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$271.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$138.06
|
| Rate for Payer: UHC Exchange |
$271.30
|
| Rate for Payer: UHC Medicaid |
$90.74
|
| Rate for Payer: UHCCP DNSP |
$138.06
|
| Rate for Payer: UHCCP Medicaid |
$90.74
|
|
|
PR BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP
|
Professional
|
Both
|
$863.00
|
|
|
Service Code
|
HCPCS 25066
|
| Min. Negotiated Rate |
$228.55 |
| Max. Negotiated Rate |
$647.25 |
| Rate for Payer: Aetna Commercial |
$462.59
|
| Rate for Payer: Aetna Medicare |
$345.22
|
| Rate for Payer: BCBS Complete |
$239.98
|
| Rate for Payer: BCBS MAPPO |
$345.22
|
| Rate for Payer: BCN Commercial |
$573.68
|
| Rate for Payer: BCN Medicare Advantage |
$345.22
|
| Rate for Payer: Cash Price |
$690.40
|
| Rate for Payer: Cash Price |
$690.40
|
| Rate for Payer: Cofinity Commercial |
$497.12
|
| Rate for Payer: Cofinity Commercial |
$462.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.22
|
| Rate for Payer: Healthscope Commercial |
$414.26
|
| Rate for Payer: Healthscope Whirlpool |
$414.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$362.48
|
| Rate for Payer: Meridian Medicaid |
$239.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$379.74
|
| Rate for Payer: Nomi Health Commercial |
$414.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$647.25
|
| Rate for Payer: PACE SWMI |
$345.22
|
| Rate for Payer: PHP Medicare Advantage |
$345.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$613.24
|
| Rate for Payer: Priority Health Medicare |
$345.22
|
| Rate for Payer: Priority Health Narrow Network |
$613.24
|
| Rate for Payer: Railroad Medicare Medicare |
$345.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$618.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$345.22
|
| Rate for Payer: UHC Exchange |
$618.78
|
| Rate for Payer: UHC Medicaid |
$228.55
|
| Rate for Payer: UHCCP DNSP |
$345.22
|
| Rate for Payer: UHCCP Medicaid |
$228.55
|
|
|
PR BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL
|
Professional
|
Both
|
$502.00
|
|
|
Service Code
|
HCPCS 25065
|
| Min. Negotiated Rate |
$93.08 |
| Max. Negotiated Rate |
$376.50 |
| Rate for Payer: Aetna Commercial |
$189.03
|
| Rate for Payer: Aetna Medicare |
$141.07
|
| Rate for Payer: BCBS Complete |
$97.73
|
| Rate for Payer: BCBS MAPPO |
$141.07
|
| Rate for Payer: BCN Commercial |
$238.54
|
| Rate for Payer: BCN Medicare Advantage |
$141.07
|
| Rate for Payer: Cash Price |
$401.60
|
| Rate for Payer: Cash Price |
$401.60
|
| Rate for Payer: Cofinity Commercial |
$203.14
|
| Rate for Payer: Cofinity Commercial |
$189.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.07
|
| Rate for Payer: Healthscope Commercial |
$169.28
|
| Rate for Payer: Healthscope Whirlpool |
$169.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.12
|
| Rate for Payer: Meridian Medicaid |
$97.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$155.18
|
| Rate for Payer: Nomi Health Commercial |
$169.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$376.50
|
| Rate for Payer: PACE SWMI |
$141.07
|
| Rate for Payer: PHP Medicare Advantage |
$141.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$254.99
|
| Rate for Payer: Priority Health Medicare |
$141.07
|
| Rate for Payer: Priority Health Narrow Network |
$254.99
|
| Rate for Payer: Railroad Medicare Medicare |
$141.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$276.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$141.07
|
| Rate for Payer: UHC Exchange |
$276.05
|
| Rate for Payer: UHC Medicaid |
$93.08
|
| Rate for Payer: UHCCP DNSP |
$141.07
|
| Rate for Payer: UHCCP Medicaid |
$93.08
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP
|
Professional
|
Both
|
$972.00
|
|
|
Service Code
|
HCPCS 27614
|
| Min. Negotiated Rate |
$249.85 |
| Max. Negotiated Rate |
$729.00 |
| Rate for Payer: Aetna Commercial |
$510.26
|
| Rate for Payer: Aetna Medicare |
$380.79
|
| Rate for Payer: BCBS Complete |
$262.34
|
| Rate for Payer: BCBS MAPPO |
$380.79
|
| Rate for Payer: BCN Commercial |
$627.96
|
| Rate for Payer: BCN Medicare Advantage |
$380.79
|
| Rate for Payer: Cash Price |
$777.60
|
| Rate for Payer: Cash Price |
$777.60
|
| Rate for Payer: Cofinity Commercial |
$548.34
|
| Rate for Payer: Cofinity Commercial |
$510.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.79
|
| Rate for Payer: Healthscope Commercial |
$456.95
|
| Rate for Payer: Healthscope Whirlpool |
$456.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.83
|
| Rate for Payer: Meridian Medicaid |
$262.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$418.87
|
| Rate for Payer: Nomi Health Commercial |
$456.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$729.00
|
| Rate for Payer: PACE SWMI |
$380.79
|
| Rate for Payer: PHP Medicare Advantage |
$380.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$671.27
|
| Rate for Payer: Priority Health Medicare |
$380.79
|
| Rate for Payer: Priority Health Narrow Network |
$671.27
|
| Rate for Payer: Railroad Medicare Medicare |
$380.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$708.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$380.79
|
| Rate for Payer: UHC Exchange |
$708.02
|
| Rate for Payer: UHC Medicaid |
$249.85
|
| Rate for Payer: UHCCP DNSP |
$380.79
|
| Rate for Payer: UHCCP Medicaid |
$249.85
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL
|
Professional
|
Both
|
$459.00
|
|
|
Service Code
|
HCPCS 27613
|
| Min. Negotiated Rate |
$96.28 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Aetna Commercial |
$196.31
|
| Rate for Payer: Aetna Medicare |
$146.50
|
| Rate for Payer: BCBS Complete |
$101.09
|
| Rate for Payer: BCBS MAPPO |
$146.50
|
| Rate for Payer: BCN Commercial |
$245.01
|
| Rate for Payer: BCN Medicare Advantage |
$146.50
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cash Price |
$367.20
|
| Rate for Payer: Cofinity Commercial |
$210.96
|
| Rate for Payer: Cofinity Commercial |
$196.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.50
|
| Rate for Payer: Healthscope Commercial |
$175.80
|
| Rate for Payer: Healthscope Whirlpool |
$175.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.82
|
| Rate for Payer: Meridian Medicaid |
$101.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.15
|
| Rate for Payer: Nomi Health Commercial |
$175.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$344.25
|
| Rate for Payer: PACE SWMI |
$146.50
|
| Rate for Payer: PHP Medicare Advantage |
$146.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$261.90
|
| Rate for Payer: Priority Health Medicare |
$146.50
|
| Rate for Payer: Priority Health Narrow Network |
$261.90
|
| Rate for Payer: Railroad Medicare Medicare |
$146.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$277.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$146.50
|
| Rate for Payer: UHC Exchange |
$277.63
|
| Rate for Payer: UHC Medicaid |
$96.28
|
| Rate for Payer: UHCCP DNSP |
$146.50
|
| Rate for Payer: UHCCP Medicaid |
$96.28
|
|
|
PR BIOPSY SOFT TISSUE NECK/THORAX
|
Professional
|
Both
|
$471.00
|
|
|
Service Code
|
HCPCS 21550
|
| Min. Negotiated Rate |
$91.59 |
| Max. Negotiated Rate |
$353.25 |
| Rate for Payer: Aetna Commercial |
$186.64
|
| Rate for Payer: Aetna Medicare |
$139.28
|
| Rate for Payer: BCBS Complete |
$96.17
|
| Rate for Payer: BCBS MAPPO |
$139.28
|
| Rate for Payer: BCN Commercial |
$234.54
|
| Rate for Payer: BCN Medicare Advantage |
$139.28
|
| Rate for Payer: Cash Price |
$376.80
|
| Rate for Payer: Cash Price |
$376.80
|
| Rate for Payer: Cofinity Commercial |
$200.56
|
| Rate for Payer: Cofinity Commercial |
$186.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.28
|
| Rate for Payer: Healthscope Commercial |
$167.14
|
| Rate for Payer: Healthscope Whirlpool |
$167.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.24
|
| Rate for Payer: Meridian Medicaid |
$96.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$153.21
|
| Rate for Payer: Nomi Health Commercial |
$167.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$353.25
|
| Rate for Payer: PACE SWMI |
$139.28
|
| Rate for Payer: PHP Medicare Advantage |
$139.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$250.72
|
| Rate for Payer: Priority Health Medicare |
$139.28
|
| Rate for Payer: Priority Health Narrow Network |
$250.72
|
| Rate for Payer: Railroad Medicare Medicare |
$139.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$269.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$139.28
|
| Rate for Payer: UHC Exchange |
$269.58
|
| Rate for Payer: UHC Medicaid |
$91.59
|
| Rate for Payer: UHCCP DNSP |
$139.28
|
| Rate for Payer: UHCCP Medicaid |
$91.59
|
|
|
PR BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL
|
Professional
|
Both
|
$615.00
|
|
|
Service Code
|
HCPCS 27040
|
| Min. Negotiated Rate |
$116.51 |
| Max. Negotiated Rate |
$461.25 |
| Rate for Payer: Aetna Commercial |
$238.77
|
| Rate for Payer: Aetna Medicare |
$178.19
|
| Rate for Payer: BCBS Complete |
$122.34
|
| Rate for Payer: BCBS MAPPO |
$178.19
|
| Rate for Payer: BCN Commercial |
$301.78
|
| Rate for Payer: BCN Medicare Advantage |
$178.19
|
| Rate for Payer: Cash Price |
$492.00
|
| Rate for Payer: Cash Price |
$492.00
|
| Rate for Payer: Cofinity Commercial |
$256.59
|
| Rate for Payer: Cofinity Commercial |
$238.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.19
|
| Rate for Payer: Healthscope Commercial |
$213.83
|
| Rate for Payer: Healthscope Whirlpool |
$213.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.10
|
| Rate for Payer: Meridian Medicaid |
$122.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$196.01
|
| Rate for Payer: Nomi Health Commercial |
$213.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$461.25
|
| Rate for Payer: PACE SWMI |
$178.19
|
| Rate for Payer: PHP Medicare Advantage |
$178.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$322.59
|
| Rate for Payer: Priority Health Medicare |
$178.19
|
| Rate for Payer: Priority Health Narrow Network |
$322.59
|
| Rate for Payer: Railroad Medicare Medicare |
$178.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$346.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$178.19
|
| Rate for Payer: UHC Exchange |
$346.57
|
| Rate for Payer: UHC Medicaid |
$116.51
|
| Rate for Payer: UHCCP DNSP |
$178.19
|
| Rate for Payer: UHCCP Medicaid |
$116.51
|
|
|
PR BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM
|
Professional
|
Both
|
$1,467.00
|
|
|
Service Code
|
HCPCS 27041
|
| Min. Negotiated Rate |
$417.69 |
| Max. Negotiated Rate |
$1,222.61 |
| Rate for Payer: Aetna Commercial |
$859.42
|
| Rate for Payer: Aetna Medicare |
$641.36
|
| Rate for Payer: BCBS Complete |
$438.57
|
| Rate for Payer: BCBS MAPPO |
$641.36
|
| Rate for Payer: BCN Commercial |
$1,074.64
|
| Rate for Payer: BCN Medicare Advantage |
$641.36
|
| Rate for Payer: Cash Price |
$1,173.60
|
| Rate for Payer: Cash Price |
$1,173.60
|
| Rate for Payer: Cofinity Commercial |
$923.56
|
| Rate for Payer: Cofinity Commercial |
$859.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.36
|
| Rate for Payer: Healthscope Commercial |
$769.63
|
| Rate for Payer: Healthscope Whirlpool |
$769.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.43
|
| Rate for Payer: Meridian Medicaid |
$438.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$705.50
|
| Rate for Payer: Nomi Health Commercial |
$769.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,100.25
|
| Rate for Payer: PACE SWMI |
$641.36
|
| Rate for Payer: PHP Medicare Advantage |
$641.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$417.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,148.77
|
| Rate for Payer: Priority Health Medicare |
$641.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,148.77
|
| Rate for Payer: Railroad Medicare Medicare |
$641.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,222.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$641.36
|
| Rate for Payer: UHC Exchange |
$1,222.61
|
| Rate for Payer: UHC Medicaid |
$417.69
|
| Rate for Payer: UHCCP DNSP |
$641.36
|
| Rate for Payer: UHCCP Medicaid |
$417.69
|
|
|
PR BIOPSY SOFT TISSUE SHOULDER DEEP
|
Professional
|
Both
|
$873.00
|
|
|
Service Code
|
HCPCS 23066
|
| Min. Negotiated Rate |
$233.66 |
| Max. Negotiated Rate |
$654.75 |
| Rate for Payer: Aetna Commercial |
$473.48
|
| Rate for Payer: Aetna Medicare |
$353.34
|
| Rate for Payer: BCBS Complete |
$245.34
|
| Rate for Payer: BCBS MAPPO |
$353.34
|
| Rate for Payer: BCN Commercial |
$570.69
|
| Rate for Payer: BCN Medicare Advantage |
$353.34
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cofinity Commercial |
$508.81
|
| Rate for Payer: Cofinity Commercial |
$473.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$353.34
|
| Rate for Payer: Healthscope Commercial |
$424.01
|
| Rate for Payer: Healthscope Whirlpool |
$424.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$371.01
|
| Rate for Payer: Meridian Medicaid |
$245.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$388.67
|
| Rate for Payer: Nomi Health Commercial |
$424.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$654.75
|
| Rate for Payer: PACE SWMI |
$353.34
|
| Rate for Payer: PHP Medicare Advantage |
$353.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$233.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$610.05
|
| Rate for Payer: Priority Health Medicare |
$353.34
|
| Rate for Payer: Priority Health Narrow Network |
$610.05
|
| Rate for Payer: Railroad Medicare Medicare |
$353.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$625.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$353.34
|
| Rate for Payer: UHC Exchange |
$625.06
|
| Rate for Payer: UHC Medicaid |
$233.66
|
| Rate for Payer: UHCCP DNSP |
$353.34
|
| Rate for Payer: UHCCP Medicaid |
$233.66
|
|
|
PR BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP
|
Professional
|
Both
|
$717.00
|
|
|
Service Code
|
HCPCS 27324
|
| Min. Negotiated Rate |
$256.67 |
| Max. Negotiated Rate |
$702.14 |
| Rate for Payer: Aetna Commercial |
$522.45
|
| Rate for Payer: Aetna Medicare |
$389.89
|
| Rate for Payer: BCBS Complete |
$269.50
|
| Rate for Payer: BCBS MAPPO |
$389.89
|
| Rate for Payer: BCN Commercial |
$630.94
|
| Rate for Payer: BCN Medicare Advantage |
$389.89
|
| Rate for Payer: Cash Price |
$573.60
|
| Rate for Payer: Cash Price |
$573.60
|
| Rate for Payer: Cofinity Commercial |
$561.44
|
| Rate for Payer: Cofinity Commercial |
$522.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.89
|
| Rate for Payer: Healthscope Commercial |
$467.87
|
| Rate for Payer: Healthscope Whirlpool |
$467.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.38
|
| Rate for Payer: Meridian Medicaid |
$269.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$428.88
|
| Rate for Payer: Nomi Health Commercial |
$467.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$537.75
|
| Rate for Payer: PACE SWMI |
$389.89
|
| Rate for Payer: PHP Medicare Advantage |
$389.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$256.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$674.46
|
| Rate for Payer: Priority Health Medicare |
$389.89
|
| Rate for Payer: Priority Health Narrow Network |
$674.46
|
| Rate for Payer: Railroad Medicare Medicare |
$389.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$702.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$389.89
|
| Rate for Payer: UHC Exchange |
$702.14
|
| Rate for Payer: UHC Medicaid |
$256.67
|
| Rate for Payer: UHCCP DNSP |
$389.89
|
| Rate for Payer: UHCCP Medicaid |
$256.67
|
|
|
PR BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL
|
Professional
|
Both
|
$495.00
|
|
|
Service Code
|
HCPCS 27323
|
| Min. Negotiated Rate |
$100.54 |
| Max. Negotiated Rate |
$371.25 |
| Rate for Payer: Aetna Commercial |
$204.62
|
| Rate for Payer: Aetna Medicare |
$152.70
|
| Rate for Payer: BCBS Complete |
$105.57
|
| Rate for Payer: BCBS MAPPO |
$152.70
|
| Rate for Payer: BCN Commercial |
$265.92
|
| Rate for Payer: BCN Medicare Advantage |
$152.70
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cofinity Commercial |
$219.89
|
| Rate for Payer: Cofinity Commercial |
$204.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.70
|
| Rate for Payer: Healthscope Commercial |
$183.24
|
| Rate for Payer: Healthscope Whirlpool |
$183.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.34
|
| Rate for Payer: Meridian Medicaid |
$105.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$167.97
|
| Rate for Payer: Nomi Health Commercial |
$183.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.25
|
| Rate for Payer: PACE SWMI |
$152.70
|
| Rate for Payer: PHP Medicare Advantage |
$152.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$284.26
|
| Rate for Payer: Priority Health Medicare |
$152.70
|
| Rate for Payer: Priority Health Narrow Network |
$284.26
|
| Rate for Payer: Railroad Medicare Medicare |
$152.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$306.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$152.70
|
| Rate for Payer: UHC Exchange |
$306.17
|
| Rate for Payer: UHC Medicaid |
$100.54
|
| Rate for Payer: UHCCP DNSP |
$152.70
|
| Rate for Payer: UHCCP Medicaid |
$100.54
|
|
|
PR BIOPSY SOFT TISSUE UPPER ARM/ELBOW AREA DEEP
|
Professional
|
Both
|
$1,105.00
|
|
|
Service Code
|
HCPCS 24066
|
| Min. Negotiated Rate |
$265.19 |
| Max. Negotiated Rate |
$828.75 |
| Rate for Payer: Aetna Commercial |
$540.68
|
| Rate for Payer: Aetna Medicare |
$403.49
|
| Rate for Payer: BCBS Complete |
$278.45
|
| Rate for Payer: BCBS MAPPO |
$403.49
|
| Rate for Payer: BCN Commercial |
$652.36
|
| Rate for Payer: BCN Medicare Advantage |
$403.49
|
| Rate for Payer: Cash Price |
$884.00
|
| Rate for Payer: Cash Price |
$884.00
|
| Rate for Payer: Cofinity Commercial |
$581.03
|
| Rate for Payer: Cofinity Commercial |
$540.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$403.49
|
| Rate for Payer: Healthscope Commercial |
$484.19
|
| Rate for Payer: Healthscope Whirlpool |
$484.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$423.66
|
| Rate for Payer: Meridian Medicaid |
$278.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$443.84
|
| Rate for Payer: Nomi Health Commercial |
$484.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$828.75
|
| Rate for Payer: PACE SWMI |
$403.49
|
| Rate for Payer: PHP Medicare Advantage |
$403.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$265.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$697.35
|
| Rate for Payer: Priority Health Medicare |
$403.49
|
| Rate for Payer: Priority Health Narrow Network |
$697.35
|
| Rate for Payer: Railroad Medicare Medicare |
$403.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$722.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$403.49
|
| Rate for Payer: UHC Exchange |
$722.24
|
| Rate for Payer: UHC Medicaid |
$265.19
|
| Rate for Payer: UHCCP DNSP |
$403.49
|
| Rate for Payer: UHCCP Medicaid |
$265.19
|
|
|
PR BIOPSY SOFT TISSUE UPPER ARM/ELBOW SUPERFICIAL
|
Professional
|
Both
|
$481.00
|
|
|
Service Code
|
HCPCS 24065
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$360.75 |
| Rate for Payer: Aetna Commercial |
$192.65
|
| Rate for Payer: Aetna Medicare |
$143.77
|
| Rate for Payer: BCBS Complete |
$99.53
|
| Rate for Payer: BCBS MAPPO |
$143.77
|
| Rate for Payer: BCN Commercial |
$246.00
|
| Rate for Payer: BCN Medicare Advantage |
$143.77
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cash Price |
$384.80
|
| Rate for Payer: Cofinity Commercial |
$207.03
|
| Rate for Payer: Cofinity Commercial |
$192.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.77
|
| Rate for Payer: Healthscope Commercial |
$172.52
|
| Rate for Payer: Healthscope Whirlpool |
$172.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.96
|
| Rate for Payer: Meridian Medicaid |
$99.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$158.15
|
| Rate for Payer: Nomi Health Commercial |
$172.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$360.75
|
| Rate for Payer: PACE SWMI |
$143.77
|
| Rate for Payer: PHP Medicare Advantage |
$143.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$262.97
|
| Rate for Payer: Priority Health Medicare |
$143.77
|
| Rate for Payer: Priority Health Narrow Network |
$262.97
|
| Rate for Payer: Railroad Medicare Medicare |
$143.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$283.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$143.77
|
| Rate for Payer: UHC Exchange |
$283.48
|
| Rate for Payer: UHC Medicaid |
$94.79
|
| Rate for Payer: UHCCP DNSP |
$143.77
|
| Rate for Payer: UHCCP Medicaid |
$94.79
|
|
|
PR BIOPSY SPINAL CORD PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$2,621.00
|
|
|
Service Code
|
HCPCS 62269
|
| Min. Negotiated Rate |
$141.65 |
| Max. Negotiated Rate |
$1,965.75 |
| Rate for Payer: Aetna Commercial |
$295.19
|
| Rate for Payer: Aetna Medicare |
$220.29
|
| Rate for Payer: BCBS Complete |
$148.73
|
| Rate for Payer: BCBS MAPPO |
$220.29
|
| Rate for Payer: BCN Commercial |
$385.94
|
| Rate for Payer: BCN Medicare Advantage |
$220.29
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cash Price |
$2,096.80
|
| Rate for Payer: Cofinity Commercial |
$317.22
|
| Rate for Payer: Cofinity Commercial |
$295.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$220.29
|
| Rate for Payer: Healthscope Commercial |
$264.35
|
| Rate for Payer: Healthscope Whirlpool |
$264.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$231.30
|
| Rate for Payer: Meridian Medicaid |
$148.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$242.32
|
| Rate for Payer: Nomi Health Commercial |
$264.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,965.75
|
| Rate for Payer: PACE SWMI |
$220.29
|
| Rate for Payer: PHP Medicare Advantage |
$220.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$141.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$448.26
|
| Rate for Payer: Priority Health Medicare |
$220.29
|
| Rate for Payer: Priority Health Narrow Network |
$448.26
|
| Rate for Payer: Railroad Medicare Medicare |
$220.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$468.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$220.29
|
| Rate for Payer: UHC Exchange |
$468.46
|
| Rate for Payer: UHC Medicaid |
$141.65
|
| Rate for Payer: UHCCP DNSP |
$220.29
|
| Rate for Payer: UHCCP Medicaid |
$141.65
|
|
|
PR BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$701.00
|
|
|
Service Code
|
HCPCS 54505
|
| Min. Negotiated Rate |
$123.11 |
| Max. Negotiated Rate |
$525.75 |
| Rate for Payer: Aetna Commercial |
$253.62
|
| Rate for Payer: Aetna Medicare |
$189.27
|
| Rate for Payer: BCBS Complete |
$129.27
|
| Rate for Payer: BCBS MAPPO |
$189.27
|
| Rate for Payer: BCN Commercial |
$315.72
|
| Rate for Payer: BCN Medicare Advantage |
$189.27
|
| Rate for Payer: Cash Price |
$560.80
|
| Rate for Payer: Cash Price |
$560.80
|
| Rate for Payer: Cofinity Commercial |
$272.55
|
| Rate for Payer: Cofinity Commercial |
$253.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.27
|
| Rate for Payer: Healthscope Commercial |
$227.12
|
| Rate for Payer: Healthscope Whirlpool |
$227.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.73
|
| Rate for Payer: Meridian Medicaid |
$129.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$208.20
|
| Rate for Payer: Nomi Health Commercial |
$227.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$525.75
|
| Rate for Payer: PACE SWMI |
$189.27
|
| Rate for Payer: PHP Medicare Advantage |
$189.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$343.93
|
| Rate for Payer: Priority Health Medicare |
$189.27
|
| Rate for Payer: Priority Health Narrow Network |
$343.93
|
| Rate for Payer: Railroad Medicare Medicare |
$189.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$369.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$189.27
|
| Rate for Payer: UHC Exchange |
$369.04
|
| Rate for Payer: UHC Medicaid |
$123.11
|
| Rate for Payer: UHCCP DNSP |
$189.27
|
| Rate for Payer: UHCCP Medicaid |
$123.11
|
|
|
PR BIOPSY THYROID PERCUTANEOUS CORE NEEDLE
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 60100
|
| Min. Negotiated Rate |
$41.75 |
| Max. Negotiated Rate |
$166.50 |
| Rate for Payer: Aetna Commercial |
$87.65
|
| Rate for Payer: Aetna Medicare |
$65.41
|
| Rate for Payer: BCBS Complete |
$43.84
|
| Rate for Payer: BCBS MAPPO |
$65.41
|
| Rate for Payer: BCN Commercial |
$112.55
|
| Rate for Payer: BCN Medicare Advantage |
$65.41
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cofinity Commercial |
$94.19
|
| Rate for Payer: Cofinity Commercial |
$87.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.41
|
| Rate for Payer: Healthscope Commercial |
$78.49
|
| Rate for Payer: Healthscope Whirlpool |
$78.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.68
|
| Rate for Payer: Meridian Medicaid |
$43.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.95
|
| Rate for Payer: Nomi Health Commercial |
$78.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.50
|
| Rate for Payer: PACE SWMI |
$65.41
|
| Rate for Payer: PHP Medicare Advantage |
$65.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$122.03
|
| Rate for Payer: Priority Health Medicare |
$65.41
|
| Rate for Payer: Priority Health Narrow Network |
$122.03
|
| Rate for Payer: Railroad Medicare Medicare |
$65.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$138.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.41
|
| Rate for Payer: UHC Exchange |
$138.30
|
| Rate for Payer: UHC Medicaid |
$41.75
|
| Rate for Payer: UHCCP DNSP |
$65.41
|
| Rate for Payer: UHCCP Medicaid |
$41.75
|
|
|
PR BIOPSY TONGUE ANTERIOR TWO-THIRDS
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 41100
|
| Min. Negotiated Rate |
$62.20 |
| Max. Negotiated Rate |
$253.50 |
| Rate for Payer: Aetna Commercial |
$126.54
|
| Rate for Payer: Aetna Medicare |
$94.43
|
| Rate for Payer: BCBS Complete |
$65.31
|
| Rate for Payer: BCBS MAPPO |
$94.43
|
| Rate for Payer: BCN Commercial |
$162.34
|
| Rate for Payer: BCN Medicare Advantage |
$94.43
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cofinity Commercial |
$135.98
|
| Rate for Payer: Cofinity Commercial |
$126.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.43
|
| Rate for Payer: Healthscope Commercial |
$113.32
|
| Rate for Payer: Healthscope Whirlpool |
$113.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.15
|
| Rate for Payer: Meridian Medicaid |
$65.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.87
|
| Rate for Payer: Nomi Health Commercial |
$113.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.50
|
| Rate for Payer: PACE SWMI |
$94.43
|
| Rate for Payer: PHP Medicare Advantage |
$94.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$197.80
|
| Rate for Payer: Priority Health Medicare |
$94.43
|
| Rate for Payer: Priority Health Narrow Network |
$197.80
|
| Rate for Payer: Railroad Medicare Medicare |
$94.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$182.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$94.43
|
| Rate for Payer: UHC Exchange |
$182.06
|
| Rate for Payer: UHC Medicaid |
$62.20
|
| Rate for Payer: UHCCP DNSP |
$94.43
|
| Rate for Payer: UHCCP Medicaid |
$62.20
|
|
|
PR BIOPSY TONGUE POSTERIOR ONE-THIRD
|
Professional
|
Both
|
$313.00
|
|
|
Service Code
|
HCPCS 41105
|
| Min. Negotiated Rate |
$64.11 |
| Max. Negotiated Rate |
$234.75 |
| Rate for Payer: Aetna Commercial |
$130.50
|
| Rate for Payer: Aetna Medicare |
$97.39
|
| Rate for Payer: BCBS Complete |
$67.32
|
| Rate for Payer: BCBS MAPPO |
$97.39
|
| Rate for Payer: BCN Commercial |
$166.82
|
| Rate for Payer: BCN Medicare Advantage |
$97.39
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cofinity Commercial |
$140.24
|
| Rate for Payer: Cofinity Commercial |
$130.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.39
|
| Rate for Payer: Healthscope Commercial |
$116.87
|
| Rate for Payer: Healthscope Whirlpool |
$116.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.26
|
| Rate for Payer: Meridian Medicaid |
$67.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.13
|
| Rate for Payer: Nomi Health Commercial |
$116.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.75
|
| Rate for Payer: PACE SWMI |
$97.39
|
| Rate for Payer: PHP Medicare Advantage |
$97.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$203.26
|
| Rate for Payer: Priority Health Medicare |
$97.39
|
| Rate for Payer: Priority Health Narrow Network |
$203.26
|
| Rate for Payer: Railroad Medicare Medicare |
$97.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.39
|
| Rate for Payer: UHC Exchange |
$187.49
|
| Rate for Payer: UHC Medicaid |
$64.11
|
| Rate for Payer: UHCCP DNSP |
$97.39
|
| Rate for Payer: UHCCP Medicaid |
$64.11
|
|
|
PR BIOPSY URETHRA
|
Professional
|
Both
|
$398.00
|
|
|
Service Code
|
HCPCS 53200
|
| Min. Negotiated Rate |
$81.58 |
| Max. Negotiated Rate |
$298.50 |
| Rate for Payer: Aetna Commercial |
$170.03
|
| Rate for Payer: Aetna Medicare |
$126.89
|
| Rate for Payer: BCBS Complete |
$85.66
|
| Rate for Payer: BCBS MAPPO |
$126.89
|
| Rate for Payer: BCN Commercial |
$212.14
|
| Rate for Payer: BCN Medicare Advantage |
$126.89
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cofinity Commercial |
$182.72
|
| Rate for Payer: Cofinity Commercial |
$170.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.89
|
| Rate for Payer: Healthscope Commercial |
$152.27
|
| Rate for Payer: Healthscope Whirlpool |
$152.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.23
|
| Rate for Payer: Meridian Medicaid |
$85.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.58
|
| Rate for Payer: Nomi Health Commercial |
$152.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.50
|
| Rate for Payer: PACE SWMI |
$126.89
|
| Rate for Payer: PHP Medicare Advantage |
$126.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$231.10
|
| Rate for Payer: Priority Health Medicare |
$126.89
|
| Rate for Payer: Priority Health Narrow Network |
$231.10
|
| Rate for Payer: Railroad Medicare Medicare |
$126.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$250.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$126.89
|
| Rate for Payer: UHC Exchange |
$250.53
|
| Rate for Payer: UHC Medicaid |
$81.58
|
| Rate for Payer: UHCCP DNSP |
$126.89
|
| Rate for Payer: UHCCP Medicaid |
$81.58
|
|
|
PR BIOPSY VAGINAL MUCOSA EXTENSIVE
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 57105
|
| Min. Negotiated Rate |
$86.48 |
| Max. Negotiated Rate |
$243.75 |
| Rate for Payer: Aetna Commercial |
$175.71
|
| Rate for Payer: Aetna Medicare |
$131.13
|
| Rate for Payer: BCBS Complete |
$90.80
|
| Rate for Payer: BCBS MAPPO |
$131.13
|
| Rate for Payer: BCN Commercial |
$220.11
|
| Rate for Payer: BCN Medicare Advantage |
$131.13
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$188.83
|
| Rate for Payer: Cofinity Commercial |
$175.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.13
|
| Rate for Payer: Healthscope Commercial |
$157.36
|
| Rate for Payer: Healthscope Whirlpool |
$157.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.69
|
| Rate for Payer: Meridian Medicaid |
$90.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$144.24
|
| Rate for Payer: Nomi Health Commercial |
$157.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: PACE SWMI |
$131.13
|
| Rate for Payer: PHP Medicare Advantage |
$131.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$222.92
|
| Rate for Payer: Priority Health Medicare |
$131.13
|
| Rate for Payer: Priority Health Narrow Network |
$222.92
|
| Rate for Payer: Railroad Medicare Medicare |
$131.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$131.13
|
| Rate for Payer: UHC Exchange |
$236.52
|
| Rate for Payer: UHC Medicaid |
$86.48
|
| Rate for Payer: UHCCP DNSP |
$131.13
|
| Rate for Payer: UHCCP Medicaid |
$86.48
|
|
|
PR BIOPSY VAGINAL MUCOSA SIMPLE
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
HCPCS 57100
|
| Min. Negotiated Rate |
$37.28 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Aetna Commercial |
$78.19
|
| Rate for Payer: Aetna Medicare |
$58.35
|
| Rate for Payer: BCBS Complete |
$39.14
|
| Rate for Payer: BCBS MAPPO |
$58.35
|
| Rate for Payer: BCN Commercial |
$98.10
|
| Rate for Payer: BCN Medicare Advantage |
$58.35
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cofinity Commercial |
$84.02
|
| Rate for Payer: Cofinity Commercial |
$78.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.35
|
| Rate for Payer: Healthscope Commercial |
$70.02
|
| Rate for Payer: Healthscope Whirlpool |
$70.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.27
|
| Rate for Payer: Meridian Medicaid |
$39.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.19
|
| Rate for Payer: Nomi Health Commercial |
$70.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.50
|
| Rate for Payer: PACE SWMI |
$58.35
|
| Rate for Payer: PHP Medicare Advantage |
$58.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$99.35
|
| Rate for Payer: Priority Health Medicare |
$58.35
|
| Rate for Payer: Priority Health Narrow Network |
$99.35
|
| Rate for Payer: Railroad Medicare Medicare |
$58.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$116.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.35
|
| Rate for Payer: UHC Exchange |
$116.53
|
| Rate for Payer: UHC Medicaid |
$37.28
|
| Rate for Payer: UHCCP DNSP |
$58.35
|
| Rate for Payer: UHCCP Medicaid |
$37.28
|
|
|
PR BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL
|
Professional
|
Both
|
$1,367.00
|
|
|
Service Code
|
HCPCS 20251
|
| Min. Negotiated Rate |
$268.59 |
| Max. Negotiated Rate |
$1,025.25 |
| Rate for Payer: Aetna Commercial |
$553.06
|
| Rate for Payer: Aetna Medicare |
$412.73
|
| Rate for Payer: BCBS Complete |
$282.02
|
| Rate for Payer: BCBS MAPPO |
$412.73
|
| Rate for Payer: BCN Commercial |
$654.35
|
| Rate for Payer: BCN Medicare Advantage |
$412.73
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cash Price |
$1,093.60
|
| Rate for Payer: Cofinity Commercial |
$594.33
|
| Rate for Payer: Cofinity Commercial |
$553.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$412.73
|
| Rate for Payer: Healthscope Commercial |
$495.28
|
| Rate for Payer: Healthscope Whirlpool |
$495.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$433.37
|
| Rate for Payer: Meridian Medicaid |
$282.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$454.00
|
| Rate for Payer: Nomi Health Commercial |
$495.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,025.25
|
| Rate for Payer: PACE SWMI |
$412.73
|
| Rate for Payer: PHP Medicare Advantage |
$412.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$699.47
|
| Rate for Payer: Priority Health Medicare |
$412.73
|
| Rate for Payer: Priority Health Narrow Network |
$699.47
|
| Rate for Payer: Railroad Medicare Medicare |
$412.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$749.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$412.73
|
| Rate for Payer: UHC Exchange |
$749.05
|
| Rate for Payer: UHC Medicaid |
$268.59
|
| Rate for Payer: UHCCP DNSP |
$412.73
|
| Rate for Payer: UHCCP Medicaid |
$268.59
|
|
