|
PR BIOPSY BONE OPEN DEEP
|
Professional
|
Both
|
$1,264.00
|
|
|
Service Code
|
HCPCS 20245
|
| Min. Negotiated Rate |
$106.88 |
| Max. Negotiated Rate |
$821.60 |
| Rate for Payer: Aetna Commercial |
$465.71
|
| Rate for Payer: Aetna Medicare |
$632.00
|
| Rate for Payer: BCBS Complete |
$229.91
|
| Rate for Payer: BCBS Trust/PPO |
$106.88
|
| Rate for Payer: BCN Commercial |
$499.92
|
| Rate for Payer: Cash Price |
$1,011.20
|
| Rate for Payer: Cash Price |
$1,011.20
|
| Rate for Payer: Meridian Medicaid |
$229.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$821.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$521.59
|
| Rate for Payer: Priority Health Narrow Network |
$521.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$723.01
|
| Rate for Payer: UHC Exchange |
$723.01
|
| Rate for Payer: UHCCP Medicaid |
$218.96
|
|
|
PR BIOPSY BONE OPEN SUPERFICIAL
|
Professional
|
Both
|
$546.00
|
|
|
Service Code
|
HCPCS 20240
|
| Min. Negotiated Rate |
$89.46 |
| Max. Negotiated Rate |
$1,002.07 |
| Rate for Payer: Aetna Commercial |
$190.88
|
| Rate for Payer: Aetna Medicare |
$273.00
|
| Rate for Payer: BCBS Complete |
$93.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,002.07
|
| Rate for Payer: BCN Commercial |
$202.32
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Meridian Medicaid |
$93.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$354.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.70
|
| Rate for Payer: Priority Health Narrow Network |
$212.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$260.39
|
| Rate for Payer: UHC Exchange |
$260.39
|
| Rate for Payer: UHCCP Medicaid |
$89.46
|
|
|
PR BIOPSY BONE TROCAR/NEEDLE DEEP
|
Professional
|
Both
|
$1,918.00
|
|
|
Service Code
|
HCPCS 20225
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$1,246.70 |
| Rate for Payer: Aetna Commercial |
$173.19
|
| Rate for Payer: Aetna Medicare |
$959.00
|
| Rate for Payer: BCBS Complete |
$86.11
|
| Rate for Payer: BCBS Trust/PPO |
$57.48
|
| Rate for Payer: BCN Commercial |
$567.36
|
| Rate for Payer: Cash Price |
$1,534.40
|
| Rate for Payer: Cash Price |
$1,534.40
|
| Rate for Payer: Meridian Medicaid |
$86.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,246.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.88
|
| Rate for Payer: Priority Health Narrow Network |
$193.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$136.86
|
| Rate for Payer: UHC Exchange |
$136.86
|
| Rate for Payer: UHCCP Medicaid |
$82.01
|
|
|
PR BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL
|
Professional
|
Both
|
$348.00
|
|
|
Service Code
|
HCPCS 20220
|
| Min. Negotiated Rate |
$55.17 |
| Max. Negotiated Rate |
$1,002.07 |
| Rate for Payer: Aetna Commercial |
$116.83
|
| Rate for Payer: Aetna Medicare |
$174.00
|
| Rate for Payer: BCBS Complete |
$57.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,002.07
|
| Rate for Payer: BCN Commercial |
$346.47
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Meridian Medicaid |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.78
|
| Rate for Payer: Priority Health Narrow Network |
$130.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.25
|
| Rate for Payer: UHC Exchange |
$90.25
|
| Rate for Payer: UHCCP Medicaid |
$55.17
|
|
|
PR BIOPSY BREAST OPEN INCISIONAL
|
Professional
|
Both
|
$570.00
|
|
|
Service Code
|
HCPCS 19101
|
| Min. Negotiated Rate |
$8.65 |
| Max. Negotiated Rate |
$485.26 |
| Rate for Payer: Aetna Commercial |
$243.74
|
| Rate for Payer: Aetna Medicare |
$285.00
|
| Rate for Payer: BCBS Complete |
$151.86
|
| Rate for Payer: BCBS Trust/PPO |
$8.65
|
| Rate for Payer: BCN Commercial |
$485.26
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Cash Price |
$456.00
|
| Rate for Payer: Meridian Medicaid |
$151.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$370.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.33
|
| Rate for Payer: Priority Health Narrow Network |
$304.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.01
|
| Rate for Payer: UHC Exchange |
$229.01
|
| Rate for Payer: UHCCP Medicaid |
$144.63
|
|
|
PR BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
HCPCS 57500
|
| Min. Negotiated Rate |
$48.35 |
| Max. Negotiated Rate |
$225.58 |
| Rate for Payer: Aetna Commercial |
$88.96
|
| Rate for Payer: Aetna Medicare |
$129.00
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCBS Trust/PPO |
$225.58
|
| Rate for Payer: BCN Commercial |
$182.59
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Meridian Medicaid |
$50.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.11
|
| Rate for Payer: Priority Health Narrow Network |
$112.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.51
|
| Rate for Payer: UHC Exchange |
$85.51
|
| Rate for Payer: UHCCP Medicaid |
$48.35
|
|
|
PR BIOPSY, EACH ADDED LESION
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS 11101
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$44.20 |
| Rate for Payer: Aetna Medicare |
$34.00
|
| Rate for Payer: BCBS Complete |
$27.20
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.20
|
|
|
PR BIOPSY EXTERNAL AUDITORY CANAL
|
Professional
|
Both
|
$239.00
|
|
|
Service Code
|
HCPCS 69105
|
| Min. Negotiated Rate |
$41.75 |
| Max. Negotiated Rate |
$2,308.67 |
| Rate for Payer: Aetna Commercial |
$69.92
|
| Rate for Payer: Aetna Medicare |
$119.50
|
| Rate for Payer: BCBS Complete |
$43.84
|
| Rate for Payer: BCBS Trust/PPO |
$2,308.67
|
| Rate for Payer: BCN Commercial |
$214.53
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Meridian Medicaid |
$43.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.38
|
| Rate for Payer: Priority Health Narrow Network |
$93.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.67
|
| Rate for Payer: UHC Exchange |
$70.67
|
| Rate for Payer: UHCCP Medicaid |
$41.75
|
|
|
PR BIOPSY EXTERNAL EAR
|
Professional
|
Both
|
$174.00
|
|
|
Service Code
|
HCPCS 69100
|
| Min. Negotiated Rate |
$29.39 |
| Max. Negotiated Rate |
$1,733.35 |
| Rate for Payer: Aetna Commercial |
$52.85
|
| Rate for Payer: Aetna Medicare |
$87.00
|
| Rate for Payer: BCBS Complete |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,733.35
|
| Rate for Payer: BCN Commercial |
$141.72
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.12
|
| Rate for Payer: Priority Health Narrow Network |
$67.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.56
|
| Rate for Payer: UHC Exchange |
$55.56
|
| Rate for Payer: UHCCP Medicaid |
$29.39
|
|
|
PR BIOPSY FLOOR MOUTH
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 41108
|
| Min. Negotiated Rate |
$59.43 |
| Max. Negotiated Rate |
$1,421.66 |
| Rate for Payer: Aetna Commercial |
$119.24
|
| Rate for Payer: Aetna Medicare |
$120.00
|
| Rate for Payer: BCBS Complete |
$62.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,421.66
|
| Rate for Payer: BCN Commercial |
$249.22
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Meridian Medicaid |
$62.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$164.65
|
| Rate for Payer: Priority Health Narrow Network |
$164.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.13
|
| Rate for Payer: UHC Exchange |
$107.13
|
| Rate for Payer: UHCCP Medicaid |
$59.43
|
|
|
PR BIOPSY HYPOPHARYNX
|
Professional
|
Both
|
$441.00
|
|
|
Service Code
|
HCPCS 42802
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$286.65 |
| Rate for Payer: Aetna Medicare |
$220.50
|
| Rate for Payer: BCBS Complete |
$176.40
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.65
|
|
|
PR BIOPSY INTRANASAL
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 30100
|
| Min. Negotiated Rate |
$44.30 |
| Max. Negotiated Rate |
$591.70 |
| Rate for Payer: Aetna Commercial |
$84.78
|
| Rate for Payer: Aetna Medicare |
$114.00
|
| Rate for Payer: BCBS Complete |
$46.52
|
| Rate for Payer: BCBS Trust/PPO |
$591.70
|
| Rate for Payer: BCN Commercial |
$208.66
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Meridian Medicaid |
$46.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.47
|
| Rate for Payer: Priority Health Narrow Network |
$95.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$76.58
|
| Rate for Payer: UHC Exchange |
$76.58
|
| Rate for Payer: UHCCP Medicaid |
$44.30
|
|
|
PR BIOPSY LIVER NEEDLE PERCUTANEOUS
|
Professional
|
Both
|
$593.00
|
|
|
Service Code
|
HCPCS 47000
|
| Min. Negotiated Rate |
$55.17 |
| Max. Negotiated Rate |
$1,914.56 |
| Rate for Payer: Aetna Commercial |
$117.26
|
| Rate for Payer: Aetna Medicare |
$296.50
|
| Rate for Payer: BCBS Complete |
$57.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,914.56
|
| Rate for Payer: BCN Commercial |
$489.65
|
| Rate for Payer: Cash Price |
$474.40
|
| Rate for Payer: Cash Price |
$474.40
|
| Rate for Payer: Meridian Medicaid |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$385.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.92
|
| Rate for Payer: Priority Health Narrow Network |
$153.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$126.54
|
| Rate for Payer: UHC Exchange |
$126.54
|
| Rate for Payer: UHCCP Medicaid |
$55.17
|
|
|
PR BIOPSY LIVER WEDGE
|
Professional
|
Both
|
$1,789.00
|
|
|
Service Code
|
HCPCS 47100
|
| Min. Negotiated Rate |
$547.20 |
| Max. Negotiated Rate |
$2,085.20 |
| Rate for Payer: Aetna Commercial |
$1,144.02
|
| Rate for Payer: Aetna Medicare |
$894.50
|
| Rate for Payer: BCBS Complete |
$574.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,085.20
|
| Rate for Payer: BCN Commercial |
$1,241.73
|
| Rate for Payer: Cash Price |
$1,431.20
|
| Rate for Payer: Cash Price |
$1,431.20
|
| Rate for Payer: Meridian Medicaid |
$574.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$547.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,526.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,526.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,000.26
|
| Rate for Payer: UHC Exchange |
$1,000.26
|
| Rate for Payer: UHCCP Medicaid |
$547.20
|
|
|
PR BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$762.00
|
|
|
Service Code
|
HCPCS 32405
|
| Min. Negotiated Rate |
$304.80 |
| Max. Negotiated Rate |
$495.30 |
| Rate for Payer: Aetna Medicare |
$381.00
|
| Rate for Payer: BCBS Complete |
$304.80
|
| Rate for Payer: Cash Price |
$609.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$495.30
|
|
|
PR BIOPSY MUSCLE DEEP
|
Professional
|
Both
|
$591.00
|
|
|
Service Code
|
HCPCS 20205
|
| Min. Negotiated Rate |
$99.68 |
| Max. Negotiated Rate |
$570.00 |
| Rate for Payer: Aetna Commercial |
$206.66
|
| Rate for Payer: Aetna Medicare |
$295.50
|
| Rate for Payer: BCBS Complete |
$104.66
|
| Rate for Payer: BCBS Trust/PPO |
$570.00
|
| Rate for Payer: BCN Commercial |
$447.63
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Cash Price |
$472.80
|
| Rate for Payer: Meridian Medicaid |
$104.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$384.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$237.13
|
| Rate for Payer: Priority Health Narrow Network |
$237.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.41
|
| Rate for Payer: UHC Exchange |
$176.41
|
| Rate for Payer: UHCCP Medicaid |
$99.68
|
|
|
PR BIOPSY MUSCLE PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$414.00
|
|
|
Service Code
|
HCPCS 20206
|
| Min. Negotiated Rate |
$36.42 |
| Max. Negotiated Rate |
$2,284.30 |
| Rate for Payer: Aetna Commercial |
$75.67
|
| Rate for Payer: Aetna Medicare |
$207.00
|
| Rate for Payer: BCBS Complete |
$38.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,284.30
|
| Rate for Payer: BCN Commercial |
$329.36
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Meridian Medicaid |
$38.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$86.00
|
| Rate for Payer: Priority Health Narrow Network |
$86.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.70
|
| Rate for Payer: UHC Exchange |
$72.70
|
| Rate for Payer: UHCCP Medicaid |
$36.42
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Facility
|
OP
|
$359.00
|
|
|
Service Code
|
CPT 20200
|
| Hospital Charge Code |
20200
|
| Min. Negotiated Rate |
$233.35 |
| Max. Negotiated Rate |
$2,460.59 |
| Rate for Payer: Aetna Commercial |
$323.10
|
| Rate for Payer: Aetna Medicare |
$1,587.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: ASR ASR |
$348.23
|
| Rate for Payer: ASR Commercial |
$348.23
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$293.99
|
| Rate for Payer: BCN Commercial |
$278.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$337.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$359.00
|
| Rate for Payer: Healthscope Whirlpool |
$348.23
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,587.48
|
| Rate for Payer: Mclaren Commercial |
$323.10
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.15
|
| Rate for Payer: Nomi Health Commercial |
$294.38
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,746.23
|
| Rate for Payer: PHP Medicaid |
$850.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$314.56
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$251.66
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$2,460.59
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP DNSP |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 20200
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$672.75 |
| Rate for Payer: Aetna Commercial |
$125.65
|
| Rate for Payer: Aetna Medicare |
$179.50
|
| Rate for Payer: BCBS Complete |
$64.86
|
| Rate for Payer: BCBS Trust/PPO |
$672.75
|
| Rate for Payer: BCN Commercial |
$321.06
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Meridian Medicaid |
$64.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.53
|
| Rate for Payer: Priority Health Narrow Network |
$145.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.88
|
| Rate for Payer: UHC Exchange |
$108.88
|
| Rate for Payer: UHCCP Medicaid |
$61.77
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Facility
|
IP
|
$359.00
|
|
|
Service Code
|
CPT 20200
|
| Hospital Charge Code |
20200
|
| Min. Negotiated Rate |
$233.35 |
| Max. Negotiated Rate |
$359.00 |
| Rate for Payer: Aetna Commercial |
$323.10
|
| Rate for Payer: ASR ASR |
$348.23
|
| Rate for Payer: ASR Commercial |
$348.23
|
| Rate for Payer: BCBS Trust/PPO |
$292.55
|
| Rate for Payer: BCN Commercial |
$278.33
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$337.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.20
|
| Rate for Payer: Healthscope Commercial |
$359.00
|
| Rate for Payer: Healthscope Whirlpool |
$348.23
|
| Rate for Payer: Mclaren Commercial |
$323.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.15
|
| Rate for Payer: Nomi Health Commercial |
$294.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$315.92
|
|
|
PR BIOPSY MUSCLE SUPERFICIAL
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 20200
|
| Hospital Charge Code |
20200
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$672.75 |
| Rate for Payer: Aetna Commercial |
$125.65
|
| Rate for Payer: Aetna Medicare |
$179.50
|
| Rate for Payer: BCBS Complete |
$64.86
|
| Rate for Payer: BCBS Trust/PPO |
$672.75
|
| Rate for Payer: BCN Commercial |
$321.06
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Meridian Medicaid |
$64.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.53
|
| Rate for Payer: Priority Health Narrow Network |
$145.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.88
|
| Rate for Payer: UHC Exchange |
$108.88
|
| Rate for Payer: UHCCP Medicaid |
$61.77
|
|
|
PR BIOPSY NAIL UNIT SEPARATE PROCEDURE
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 11755
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$144.11 |
| Rate for Payer: Aetna Commercial |
$63.74
|
| Rate for Payer: Aetna Medicare |
$110.50
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS Trust/PPO |
$28.95
|
| Rate for Payer: BCN Commercial |
$144.11
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Meridian Medicaid |
$40.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.28
|
| Rate for Payer: Priority Health Narrow Network |
$81.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$87.09
|
| Rate for Payer: UHC Exchange |
$87.09
|
| Rate for Payer: UHCCP Medicaid |
$38.55
|
|
|
PR BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE
|
Professional
|
Both
|
$838.00
|
|
|
Service Code
|
HCPCS 42804
|
| Min. Negotiated Rate |
$79.45 |
| Max. Negotiated Rate |
$544.70 |
| Rate for Payer: Aetna Commercial |
$153.57
|
| Rate for Payer: Aetna Medicare |
$419.00
|
| Rate for Payer: BCBS Complete |
$83.42
|
| Rate for Payer: BCBS Trust/PPO |
$212.38
|
| Rate for Payer: BCN Commercial |
$319.11
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Meridian Medicaid |
$83.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.13
|
| Rate for Payer: Priority Health Narrow Network |
$223.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.73
|
| Rate for Payer: UHC Exchange |
$137.73
|
| Rate for Payer: UHCCP Medicaid |
$79.45
|
|
|
PR BIOPSY NERVE
|
Professional
|
Both
|
$722.00
|
|
|
Service Code
|
HCPCS 64795
|
| Min. Negotiated Rate |
$127.37 |
| Max. Negotiated Rate |
$469.30 |
| Rate for Payer: Aetna Commercial |
$245.85
|
| Rate for Payer: Aetna Medicare |
$361.00
|
| Rate for Payer: BCBS Complete |
$133.74
|
| Rate for Payer: BCBS Trust/PPO |
$218.19
|
| Rate for Payer: BCN Commercial |
$282.46
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Meridian Medicaid |
$133.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$333.26
|
| Rate for Payer: Priority Health Narrow Network |
$333.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$230.04
|
| Rate for Payer: UHC Exchange |
$230.04
|
| Rate for Payer: UHCCP Medicaid |
$127.37
|
|
|
PR BIOPSY OF LIP
|
Professional
|
Both
|
$228.00
|
|
|
Service Code
|
HCPCS 40490
|
| Min. Negotiated Rate |
$44.30 |
| Max. Negotiated Rate |
$637.13 |
| Rate for Payer: Aetna Commercial |
$92.65
|
| Rate for Payer: Aetna Medicare |
$114.00
|
| Rate for Payer: BCBS Complete |
$46.52
|
| Rate for Payer: BCBS Trust/PPO |
$637.13
|
| Rate for Payer: BCN Commercial |
$144.50
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Meridian Medicaid |
$46.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$122.89
|
| Rate for Payer: Priority Health Narrow Network |
$122.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.99
|
| Rate for Payer: UHC Exchange |
$91.99
|
| Rate for Payer: UHCCP Medicaid |
$44.30
|
|
