|
PR BRIEF COMMUNICATION TECH-BSD SVC EST PT 5-10 MIN
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 98016
|
| Min. Negotiated Rate |
$8.31 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Aetna Commercial |
$17.30
|
| Rate for Payer: Aetna Medicare |
$12.91
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCBS MAPPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$16.34
|
| Rate for Payer: BCN Medicare Advantage |
$12.91
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$17.30
|
| Rate for Payer: Cofinity Commercial |
$18.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.91
|
| Rate for Payer: Healthscope Commercial |
$15.49
|
| Rate for Payer: Healthscope Whirlpool |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.56
|
| Rate for Payer: Meridian Medicaid |
$8.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.20
|
| Rate for Payer: Nomi Health Commercial |
$15.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$12.91
|
| Rate for Payer: PHP Medicare Advantage |
$12.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$20.16
|
| Rate for Payer: Priority Health Medicare |
$12.91
|
| Rate for Payer: Priority Health Narrow Network |
$20.16
|
| Rate for Payer: Railroad Medicare Medicare |
$12.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.91
|
| Rate for Payer: UHC Exchange |
$22.49
|
| Rate for Payer: UHC Medicaid |
$8.31
|
| Rate for Payer: UHCCP DNSP |
$12.91
|
| Rate for Payer: UHCCP Medicaid |
$8.31
|
|
|
PR BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 94060
|
| Min. Negotiated Rate |
$21.75 |
| Max. Negotiated Rate |
$90.27 |
| Rate for Payer: Aetna Commercial |
$54.14
|
| Rate for Payer: Aetna Commercial |
$54.14
|
| Rate for Payer: Aetna Medicare |
$40.40
|
| Rate for Payer: Aetna Medicare |
$40.40
|
| Rate for Payer: BCBS MAPPO |
$40.40
|
| Rate for Payer: BCBS MAPPO |
$40.40
|
| Rate for Payer: BCN Commercial |
$58.26
|
| Rate for Payer: BCN Commercial |
$58.26
|
| Rate for Payer: BCN Medicare Advantage |
$40.40
|
| Rate for Payer: BCN Medicare Advantage |
$40.40
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cofinity Commercial |
$54.14
|
| Rate for Payer: Cofinity Commercial |
$58.18
|
| Rate for Payer: Cofinity Commercial |
$54.14
|
| Rate for Payer: Cofinity Commercial |
$58.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.40
|
| Rate for Payer: Healthscope Commercial |
$48.48
|
| Rate for Payer: Healthscope Commercial |
$48.48
|
| Rate for Payer: Healthscope Whirlpool |
$48.48
|
| Rate for Payer: Healthscope Whirlpool |
$48.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.44
|
| Rate for Payer: Nomi Health Commercial |
$48.48
|
| Rate for Payer: Nomi Health Commercial |
$48.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.25
|
| Rate for Payer: PACE SWMI |
$40.40
|
| Rate for Payer: PACE SWMI |
$40.40
|
| Rate for Payer: PHP Medicare Advantage |
$40.40
|
| Rate for Payer: PHP Medicare Advantage |
$40.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$85.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$85.70
|
| Rate for Payer: Priority Health Medicare |
$40.40
|
| Rate for Payer: Priority Health Medicare |
$40.40
|
| Rate for Payer: Priority Health Narrow Network |
$85.70
|
| Rate for Payer: Priority Health Narrow Network |
$85.70
|
| Rate for Payer: Railroad Medicare Medicare |
$40.40
|
| Rate for Payer: Railroad Medicare Medicare |
$40.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$90.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.40
|
| Rate for Payer: UHC Exchange |
$90.27
|
| Rate for Payer: UHC Exchange |
$90.27
|
| Rate for Payer: UHCCP DNSP |
$40.40
|
| Rate for Payer: UHCCP DNSP |
$40.40
|
|
|
PR BRNCHSC BRUSHING/PROTECTED BRUSHINGS
|
Professional
|
Both
|
$668.00
|
|
|
Service Code
|
HCPCS 31623
|
| Min. Negotiated Rate |
$76.04 |
| Max. Negotiated Rate |
$501.00 |
| Rate for Payer: Aetna Commercial |
$158.17
|
| Rate for Payer: Aetna Medicare |
$118.04
|
| Rate for Payer: BCBS Complete |
$79.84
|
| Rate for Payer: BCBS MAPPO |
$118.04
|
| Rate for Payer: BCN Commercial |
$193.22
|
| Rate for Payer: BCN Medicare Advantage |
$118.04
|
| Rate for Payer: Cash Price |
$534.40
|
| Rate for Payer: Cash Price |
$534.40
|
| Rate for Payer: Cofinity Commercial |
$169.98
|
| Rate for Payer: Cofinity Commercial |
$158.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.04
|
| Rate for Payer: Healthscope Commercial |
$141.65
|
| Rate for Payer: Healthscope Whirlpool |
$141.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.94
|
| Rate for Payer: Meridian Medicaid |
$79.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$129.84
|
| Rate for Payer: Nomi Health Commercial |
$141.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$501.00
|
| Rate for Payer: PACE SWMI |
$118.04
|
| Rate for Payer: PHP Medicare Advantage |
$118.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$181.95
|
| Rate for Payer: Priority Health Medicare |
$118.04
|
| Rate for Payer: Priority Health Narrow Network |
$181.95
|
| Rate for Payer: Railroad Medicare Medicare |
$118.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$234.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.04
|
| Rate for Payer: UHC Exchange |
$234.69
|
| Rate for Payer: UHC Medicaid |
$76.04
|
| Rate for Payer: UHCCP DNSP |
$118.04
|
| Rate for Payer: UHCCP Medicaid |
$76.04
|
|
|
PR BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX
|
Professional
|
Both
|
$496.00
|
|
|
Service Code
|
HCPCS 31652
|
| Min. Negotiated Rate |
$126.31 |
| Max. Negotiated Rate |
$392.44 |
| Rate for Payer: Aetna Commercial |
$263.42
|
| Rate for Payer: Aetna Medicare |
$196.58
|
| Rate for Payer: BCBS Complete |
$132.63
|
| Rate for Payer: BCBS MAPPO |
$196.58
|
| Rate for Payer: BCN Commercial |
$322.69
|
| Rate for Payer: BCN Medicare Advantage |
$196.58
|
| Rate for Payer: Cash Price |
$396.80
|
| Rate for Payer: Cash Price |
$396.80
|
| Rate for Payer: Cofinity Commercial |
$283.08
|
| Rate for Payer: Cofinity Commercial |
$263.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.58
|
| Rate for Payer: Healthscope Commercial |
$235.90
|
| Rate for Payer: Healthscope Whirlpool |
$235.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.41
|
| Rate for Payer: Meridian Medicaid |
$132.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$216.24
|
| Rate for Payer: Nomi Health Commercial |
$235.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$372.00
|
| Rate for Payer: PACE SWMI |
$196.58
|
| Rate for Payer: PHP Medicare Advantage |
$196.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$303.89
|
| Rate for Payer: Priority Health Medicare |
$196.58
|
| Rate for Payer: Priority Health Narrow Network |
$303.89
|
| Rate for Payer: Railroad Medicare Medicare |
$196.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$392.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$196.58
|
| Rate for Payer: UHC Exchange |
$392.44
|
| Rate for Payer: UHC Medicaid |
$126.31
|
| Rate for Payer: UHCCP DNSP |
$196.58
|
| Rate for Payer: UHCCP Medicaid |
$126.31
|
|
|
PR BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX
|
Professional
|
Both
|
$548.00
|
|
|
Service Code
|
HCPCS 31653
|
| Min. Negotiated Rate |
$139.73 |
| Max. Negotiated Rate |
$435.59 |
| Rate for Payer: Aetna Commercial |
$291.45
|
| Rate for Payer: Aetna Medicare |
$217.50
|
| Rate for Payer: BCBS Complete |
$146.72
|
| Rate for Payer: BCBS MAPPO |
$217.50
|
| Rate for Payer: BCN Commercial |
$357.55
|
| Rate for Payer: BCN Medicare Advantage |
$217.50
|
| Rate for Payer: Cash Price |
$438.40
|
| Rate for Payer: Cash Price |
$438.40
|
| Rate for Payer: Cofinity Commercial |
$313.20
|
| Rate for Payer: Cofinity Commercial |
$291.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.50
|
| Rate for Payer: Healthscope Commercial |
$261.00
|
| Rate for Payer: Healthscope Whirlpool |
$261.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.38
|
| Rate for Payer: Meridian Medicaid |
$146.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$239.25
|
| Rate for Payer: Nomi Health Commercial |
$261.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$411.00
|
| Rate for Payer: PACE SWMI |
$217.50
|
| Rate for Payer: PHP Medicare Advantage |
$217.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$336.71
|
| Rate for Payer: Priority Health Medicare |
$217.50
|
| Rate for Payer: Priority Health Narrow Network |
$336.71
|
| Rate for Payer: Railroad Medicare Medicare |
$217.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$435.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$217.50
|
| Rate for Payer: UHC Exchange |
$435.59
|
| Rate for Payer: UHC Medicaid |
$139.73
|
| Rate for Payer: UHCCP DNSP |
$217.50
|
| Rate for Payer: UHCCP Medicaid |
$139.73
|
|
|
PR BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX
|
Professional
|
Both
|
$614.00
|
|
|
Service Code
|
HCPCS 31622
|
| Min. Negotiated Rate |
$76.68 |
| Max. Negotiated Rate |
$460.50 |
| Rate for Payer: Aetna Commercial |
$159.62
|
| Rate for Payer: Aetna Medicare |
$119.12
|
| Rate for Payer: BCBS Complete |
$80.51
|
| Rate for Payer: BCBS MAPPO |
$119.12
|
| Rate for Payer: BCN Commercial |
$213.36
|
| Rate for Payer: BCN Medicare Advantage |
$119.12
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cash Price |
$491.20
|
| Rate for Payer: Cofinity Commercial |
$171.53
|
| Rate for Payer: Cofinity Commercial |
$159.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.12
|
| Rate for Payer: Healthscope Commercial |
$142.94
|
| Rate for Payer: Healthscope Whirlpool |
$142.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.08
|
| Rate for Payer: Meridian Medicaid |
$80.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$131.03
|
| Rate for Payer: Nomi Health Commercial |
$142.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$460.50
|
| Rate for Payer: PACE SWMI |
$119.12
|
| Rate for Payer: PHP Medicare Advantage |
$119.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$182.89
|
| Rate for Payer: Priority Health Medicare |
$119.12
|
| Rate for Payer: Priority Health Narrow Network |
$182.89
|
| Rate for Payer: Railroad Medicare Medicare |
$119.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$232.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$119.12
|
| Rate for Payer: UHC Exchange |
$232.69
|
| Rate for Payer: UHC Medicaid |
$76.68
|
| Rate for Payer: UHCCP DNSP |
$119.12
|
| Rate for Payer: UHCCP Medicaid |
$76.68
|
|
|
PR BRNCHSC W/BRNCL ALVEOLAR LAVAGE
|
Professional
|
Both
|
$623.00
|
|
|
Service Code
|
HCPCS 31624
|
| Min. Negotiated Rate |
$77.11 |
| Max. Negotiated Rate |
$467.25 |
| Rate for Payer: Aetna Commercial |
$160.21
|
| Rate for Payer: Aetna Medicare |
$119.56
|
| Rate for Payer: BCBS Complete |
$80.97
|
| Rate for Payer: BCBS MAPPO |
$119.56
|
| Rate for Payer: BCN Commercial |
$196.20
|
| Rate for Payer: BCN Medicare Advantage |
$119.56
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cash Price |
$498.40
|
| Rate for Payer: Cofinity Commercial |
$172.17
|
| Rate for Payer: Cofinity Commercial |
$160.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.56
|
| Rate for Payer: Healthscope Commercial |
$143.47
|
| Rate for Payer: Healthscope Whirlpool |
$143.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.54
|
| Rate for Payer: Meridian Medicaid |
$80.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$131.52
|
| Rate for Payer: Nomi Health Commercial |
$143.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$467.25
|
| Rate for Payer: PACE SWMI |
$119.56
|
| Rate for Payer: PHP Medicare Advantage |
$119.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$184.77
|
| Rate for Payer: Priority Health Medicare |
$119.56
|
| Rate for Payer: Priority Health Narrow Network |
$184.77
|
| Rate for Payer: Railroad Medicare Medicare |
$119.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$237.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$119.56
|
| Rate for Payer: UHC Exchange |
$237.61
|
| Rate for Payer: UHC Medicaid |
$77.11
|
| Rate for Payer: UHCCP DNSP |
$119.56
|
| Rate for Payer: UHCCP Medicaid |
$77.11
|
|
|
PR BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX
|
Professional
|
Both
|
$388.00
|
|
|
Service Code
|
HCPCS 31630
|
| Min. Negotiated Rate |
$112.68 |
| Max. Negotiated Rate |
$351.27 |
| Rate for Payer: Aetna Commercial |
$234.86
|
| Rate for Payer: Aetna Medicare |
$175.27
|
| Rate for Payer: BCBS Complete |
$118.31
|
| Rate for Payer: BCBS MAPPO |
$175.27
|
| Rate for Payer: BCN Commercial |
$291.32
|
| Rate for Payer: BCN Medicare Advantage |
$175.27
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cofinity Commercial |
$252.39
|
| Rate for Payer: Cofinity Commercial |
$234.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.27
|
| Rate for Payer: Healthscope Commercial |
$210.32
|
| Rate for Payer: Healthscope Whirlpool |
$210.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.03
|
| Rate for Payer: Meridian Medicaid |
$118.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.80
|
| Rate for Payer: Nomi Health Commercial |
$210.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$291.00
|
| Rate for Payer: PACE SWMI |
$175.27
|
| Rate for Payer: PHP Medicare Advantage |
$175.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$274.34
|
| Rate for Payer: Priority Health Medicare |
$175.27
|
| Rate for Payer: Priority Health Narrow Network |
$274.34
|
| Rate for Payer: Railroad Medicare Medicare |
$175.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$351.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$175.27
|
| Rate for Payer: UHC Exchange |
$351.27
|
| Rate for Payer: UHC Medicaid |
$112.68
|
| Rate for Payer: UHCCP DNSP |
$175.27
|
| Rate for Payer: UHCCP Medicaid |
$112.68
|
|
|
PR BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT
|
Professional
|
Both
|
$142.00
|
|
|
Service Code
|
HCPCS 94070
|
| Min. Negotiated Rate |
$65.81 |
| Max. Negotiated Rate |
$106.50 |
| Rate for Payer: Aetna Commercial |
$88.19
|
| Rate for Payer: Aetna Commercial |
$88.19
|
| Rate for Payer: Aetna Medicare |
$65.81
|
| Rate for Payer: Aetna Medicare |
$65.81
|
| Rate for Payer: BCBS MAPPO |
$65.81
|
| Rate for Payer: BCBS MAPPO |
$65.81
|
| Rate for Payer: BCN Commercial |
$94.61
|
| Rate for Payer: BCN Commercial |
$94.61
|
| Rate for Payer: BCN Medicare Advantage |
$65.81
|
| Rate for Payer: BCN Medicare Advantage |
$65.81
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$88.19
|
| Rate for Payer: Cofinity Commercial |
$94.77
|
| Rate for Payer: Cofinity Commercial |
$88.19
|
| Rate for Payer: Cofinity Commercial |
$94.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.81
|
| Rate for Payer: Healthscope Commercial |
$78.97
|
| Rate for Payer: Healthscope Commercial |
$78.97
|
| Rate for Payer: Healthscope Whirlpool |
$78.97
|
| Rate for Payer: Healthscope Whirlpool |
$78.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.39
|
| Rate for Payer: Nomi Health Commercial |
$78.97
|
| Rate for Payer: Nomi Health Commercial |
$78.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.50
|
| Rate for Payer: PACE SWMI |
$65.81
|
| Rate for Payer: PACE SWMI |
$65.81
|
| Rate for Payer: PHP Medicare Advantage |
$65.81
|
| Rate for Payer: PHP Medicare Advantage |
$65.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$87.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$87.26
|
| Rate for Payer: Priority Health Medicare |
$65.81
|
| Rate for Payer: Priority Health Medicare |
$65.81
|
| Rate for Payer: Priority Health Narrow Network |
$87.26
|
| Rate for Payer: Priority Health Narrow Network |
$87.26
|
| Rate for Payer: Railroad Medicare Medicare |
$65.81
|
| Rate for Payer: Railroad Medicare Medicare |
$65.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$91.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$65.81
|
| Rate for Payer: UHC Exchange |
$91.90
|
| Rate for Payer: UHC Exchange |
$91.90
|
| Rate for Payer: UHCCP DNSP |
$65.81
|
| Rate for Payer: UHCCP DNSP |
$65.81
|
|
|
PR BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 31654
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$166.50 |
| Rate for Payer: Aetna Commercial |
$79.74
|
| Rate for Payer: Aetna Medicare |
$59.51
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS MAPPO |
$59.51
|
| Rate for Payer: BCN Commercial |
$97.60
|
| Rate for Payer: BCN Medicare Advantage |
$59.51
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cofinity Commercial |
$85.69
|
| Rate for Payer: Cofinity Commercial |
$79.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.51
|
| Rate for Payer: Healthscope Commercial |
$71.41
|
| Rate for Payer: Healthscope Whirlpool |
$71.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.49
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.46
|
| Rate for Payer: Nomi Health Commercial |
$71.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.50
|
| Rate for Payer: PACE SWMI |
$59.51
|
| Rate for Payer: PHP Medicare Advantage |
$59.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$91.92
|
| Rate for Payer: Priority Health Medicare |
$59.51
|
| Rate for Payer: Priority Health Narrow Network |
$91.92
|
| Rate for Payer: Railroad Medicare Medicare |
$59.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$119.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$59.51
|
| Rate for Payer: UHC Exchange |
$119.52
|
| Rate for Payer: UHC Medicaid |
$38.13
|
| Rate for Payer: UHCCP DNSP |
$59.51
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
|
|
PR BRONCHOPLASTY GRAFT REPAIR
|
Professional
|
Both
|
$3,042.00
|
|
|
Service Code
|
HCPCS 31770
|
| Min. Negotiated Rate |
$799.18 |
| Max. Negotiated Rate |
$2,362.68 |
| Rate for Payer: Aetna Commercial |
$1,678.34
|
| Rate for Payer: Aetna Medicare |
$1,252.49
|
| Rate for Payer: BCBS Complete |
$839.14
|
| Rate for Payer: BCBS MAPPO |
$1,252.49
|
| Rate for Payer: BCN Commercial |
$1,960.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,252.49
|
| Rate for Payer: Cash Price |
$2,433.60
|
| Rate for Payer: Cash Price |
$2,433.60
|
| Rate for Payer: Cofinity Commercial |
$1,803.59
|
| Rate for Payer: Cofinity Commercial |
$1,678.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,252.49
|
| Rate for Payer: Healthscope Commercial |
$1,502.99
|
| Rate for Payer: Healthscope Whirlpool |
$1,502.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,315.11
|
| Rate for Payer: Meridian Medicaid |
$839.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,377.74
|
| Rate for Payer: Nomi Health Commercial |
$1,502.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,281.50
|
| Rate for Payer: PACE SWMI |
$1,252.49
|
| Rate for Payer: PHP Medicare Advantage |
$1,252.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$799.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,846.26
|
| Rate for Payer: Priority Health Medicare |
$1,252.49
|
| Rate for Payer: Priority Health Narrow Network |
$1,846.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,252.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,362.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,252.49
|
| Rate for Payer: UHC Exchange |
$2,362.68
|
| Rate for Payer: UHC Medicaid |
$799.18
|
| Rate for Payer: UHCCP DNSP |
$1,252.49
|
| Rate for Payer: UHCCP Medicaid |
$799.18
|
|
|
PR BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES
|
Professional
|
Both
|
$667.00
|
|
|
Service Code
|
HCPCS 31625
|
| Min. Negotiated Rate |
$89.67 |
| Max. Negotiated Rate |
$500.25 |
| Rate for Payer: Aetna Commercial |
$186.73
|
| Rate for Payer: Aetna Medicare |
$139.35
|
| Rate for Payer: BCBS Complete |
$94.15
|
| Rate for Payer: BCBS MAPPO |
$139.35
|
| Rate for Payer: BCN Commercial |
$228.07
|
| Rate for Payer: BCN Medicare Advantage |
$139.35
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cash Price |
$533.60
|
| Rate for Payer: Cofinity Commercial |
$200.66
|
| Rate for Payer: Cofinity Commercial |
$186.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.35
|
| Rate for Payer: Healthscope Commercial |
$167.22
|
| Rate for Payer: Healthscope Whirlpool |
$167.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.32
|
| Rate for Payer: Meridian Medicaid |
$94.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$153.28
|
| Rate for Payer: Nomi Health Commercial |
$167.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$500.25
|
| Rate for Payer: PACE SWMI |
$139.35
|
| Rate for Payer: PHP Medicare Advantage |
$139.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$214.78
|
| Rate for Payer: Priority Health Medicare |
$139.35
|
| Rate for Payer: Priority Health Narrow Network |
$214.78
|
| Rate for Payer: Railroad Medicare Medicare |
$139.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$276.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$139.35
|
| Rate for Payer: UHC Exchange |
$276.59
|
| Rate for Payer: UHC Medicaid |
$89.67
|
| Rate for Payer: UHCCP DNSP |
$139.35
|
| Rate for Payer: UHCCP Medicaid |
$89.67
|
|
|
PR BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON
|
Professional
|
Both
|
$1,297.00
|
|
|
Service Code
|
HCPCS 31629
|
| Min. Negotiated Rate |
$107.35 |
| Max. Negotiated Rate |
$972.75 |
| Rate for Payer: Aetna Commercial |
$223.69
|
| Rate for Payer: Aetna Medicare |
$166.93
|
| Rate for Payer: BCBS Complete |
$112.72
|
| Rate for Payer: BCBS MAPPO |
$166.93
|
| Rate for Payer: BCN Commercial |
$273.39
|
| Rate for Payer: BCN Medicare Advantage |
$166.93
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cash Price |
$1,037.60
|
| Rate for Payer: Cofinity Commercial |
$240.38
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.93
|
| Rate for Payer: Healthscope Commercial |
$200.32
|
| Rate for Payer: Healthscope Whirlpool |
$200.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.28
|
| Rate for Payer: Meridian Medicaid |
$112.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$183.62
|
| Rate for Payer: Nomi Health Commercial |
$200.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$972.75
|
| Rate for Payer: PACE SWMI |
$166.93
|
| Rate for Payer: PHP Medicare Advantage |
$166.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$257.45
|
| Rate for Payer: Priority Health Medicare |
$166.93
|
| Rate for Payer: Priority Health Narrow Network |
$257.45
|
| Rate for Payer: Railroad Medicare Medicare |
$166.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$330.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$166.93
|
| Rate for Payer: UHC Exchange |
$330.20
|
| Rate for Payer: UHC Medicaid |
$107.35
|
| Rate for Payer: UHCCP DNSP |
$166.93
|
| Rate for Payer: UHCCP Medicaid |
$107.35
|
|
|
PR BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION
|
Professional
|
Both
|
$178.00
|
|
|
Service Code
|
HCPCS 31627
|
| Min. Negotiated Rate |
$54.32 |
| Max. Negotiated Rate |
$171.36 |
| Rate for Payer: Aetna Commercial |
$113.73
|
| Rate for Payer: Aetna Medicare |
$84.87
|
| Rate for Payer: BCBS Complete |
$57.04
|
| Rate for Payer: BCBS MAPPO |
$84.87
|
| Rate for Payer: BCN Commercial |
$140.43
|
| Rate for Payer: BCN Medicare Advantage |
$84.87
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Cash Price |
$142.40
|
| Rate for Payer: Cofinity Commercial |
$122.21
|
| Rate for Payer: Cofinity Commercial |
$113.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.87
|
| Rate for Payer: Healthscope Commercial |
$101.84
|
| Rate for Payer: Healthscope Whirlpool |
$101.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.11
|
| Rate for Payer: Meridian Medicaid |
$57.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$93.36
|
| Rate for Payer: Nomi Health Commercial |
$101.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$133.50
|
| Rate for Payer: PACE SWMI |
$84.87
|
| Rate for Payer: PHP Medicare Advantage |
$84.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$132.25
|
| Rate for Payer: Priority Health Medicare |
$84.87
|
| Rate for Payer: Priority Health Narrow Network |
$132.25
|
| Rate for Payer: Railroad Medicare Medicare |
$84.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$84.87
|
| Rate for Payer: UHC Exchange |
$171.36
|
| Rate for Payer: UHC Medicaid |
$54.32
|
| Rate for Payer: UHCCP DNSP |
$84.87
|
| Rate for Payer: UHCCP Medicaid |
$54.32
|
|
|
PR BRONCHOSCOPY W/EXCISION TUMOR
|
Professional
|
Both
|
$537.00
|
|
|
Service Code
|
HCPCS 31640
|
| Min. Negotiated Rate |
$139.09 |
| Max. Negotiated Rate |
$443.18 |
| Rate for Payer: Aetna Commercial |
$289.82
|
| Rate for Payer: Aetna Medicare |
$216.28
|
| Rate for Payer: BCBS Complete |
$146.04
|
| Rate for Payer: BCBS MAPPO |
$216.28
|
| Rate for Payer: BCN Commercial |
$360.54
|
| Rate for Payer: BCN Medicare Advantage |
$216.28
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cash Price |
$429.60
|
| Rate for Payer: Cofinity Commercial |
$311.44
|
| Rate for Payer: Cofinity Commercial |
$289.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.28
|
| Rate for Payer: Healthscope Commercial |
$259.54
|
| Rate for Payer: Healthscope Whirlpool |
$259.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.09
|
| Rate for Payer: Meridian Medicaid |
$146.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$237.91
|
| Rate for Payer: Nomi Health Commercial |
$259.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$402.75
|
| Rate for Payer: PACE SWMI |
$216.28
|
| Rate for Payer: PHP Medicare Advantage |
$216.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$339.52
|
| Rate for Payer: Priority Health Medicare |
$216.28
|
| Rate for Payer: Priority Health Narrow Network |
$339.52
|
| Rate for Payer: Railroad Medicare Medicare |
$216.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$443.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$216.28
|
| Rate for Payer: UHC Exchange |
$443.18
|
| Rate for Payer: UHC Medicaid |
$139.09
|
| Rate for Payer: UHCCP DNSP |
$216.28
|
| Rate for Payer: UHCCP Medicaid |
$139.09
|
|
|
PR BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT
|
Professional
|
Both
|
$788.00
|
|
|
Service Code
|
HCPCS 31631
|
| Min. Negotiated Rate |
$127.37 |
| Max. Negotiated Rate |
$591.00 |
| Rate for Payer: Aetna Commercial |
$265.55
|
| Rate for Payer: Aetna Medicare |
$198.17
|
| Rate for Payer: BCBS Complete |
$133.74
|
| Rate for Payer: BCBS MAPPO |
$198.17
|
| Rate for Payer: BCN Commercial |
$332.15
|
| Rate for Payer: BCN Medicare Advantage |
$198.17
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cash Price |
$630.40
|
| Rate for Payer: Cofinity Commercial |
$285.36
|
| Rate for Payer: Cofinity Commercial |
$265.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.17
|
| Rate for Payer: Healthscope Commercial |
$237.80
|
| Rate for Payer: Healthscope Whirlpool |
$237.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.08
|
| Rate for Payer: Meridian Medicaid |
$133.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$217.99
|
| Rate for Payer: Nomi Health Commercial |
$237.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$591.00
|
| Rate for Payer: PACE SWMI |
$198.17
|
| Rate for Payer: PHP Medicare Advantage |
$198.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$312.79
|
| Rate for Payer: Priority Health Medicare |
$198.17
|
| Rate for Payer: Priority Health Narrow Network |
$312.79
|
| Rate for Payer: Railroad Medicare Medicare |
$198.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$403.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$198.17
|
| Rate for Payer: UHC Exchange |
$403.00
|
| Rate for Payer: UHC Medicaid |
$127.37
|
| Rate for Payer: UHCCP DNSP |
$198.17
|
| Rate for Payer: UHCCP Medicaid |
$127.37
|
|
|
PR BRONCHOSCOPY W/REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$1,171.00
|
|
|
Service Code
|
HCPCS 31635
|
| Min. Negotiated Rate |
$100.96 |
| Max. Negotiated Rate |
$878.25 |
| Rate for Payer: Aetna Commercial |
$210.14
|
| Rate for Payer: Aetna Medicare |
$156.82
|
| Rate for Payer: BCBS Complete |
$106.01
|
| Rate for Payer: BCBS MAPPO |
$156.82
|
| Rate for Payer: BCN Commercial |
$256.96
|
| Rate for Payer: BCN Medicare Advantage |
$156.82
|
| Rate for Payer: Cash Price |
$936.80
|
| Rate for Payer: Cash Price |
$936.80
|
| Rate for Payer: Cofinity Commercial |
$225.82
|
| Rate for Payer: Cofinity Commercial |
$210.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.82
|
| Rate for Payer: Healthscope Commercial |
$188.18
|
| Rate for Payer: Healthscope Whirlpool |
$188.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.66
|
| Rate for Payer: Meridian Medicaid |
$106.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$172.50
|
| Rate for Payer: Nomi Health Commercial |
$188.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$878.25
|
| Rate for Payer: PACE SWMI |
$156.82
|
| Rate for Payer: PHP Medicare Advantage |
$156.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$241.98
|
| Rate for Payer: Priority Health Medicare |
$156.82
|
| Rate for Payer: Priority Health Narrow Network |
$241.98
|
| Rate for Payer: Railroad Medicare Medicare |
$156.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$310.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$156.82
|
| Rate for Payer: UHC Exchange |
$310.78
|
| Rate for Payer: UHC Medicaid |
$100.96
|
| Rate for Payer: UHCCP DNSP |
$156.82
|
| Rate for Payer: UHCCP Medicaid |
$100.96
|
|
|
PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST
|
Professional
|
Both
|
$710.00
|
|
|
Service Code
|
HCPCS 31645
|
| Min. Negotiated Rate |
$84.99 |
| Max. Negotiated Rate |
$532.50 |
| Rate for Payer: Aetna Commercial |
$176.79
|
| Rate for Payer: Aetna Medicare |
$131.93
|
| Rate for Payer: BCBS Complete |
$89.24
|
| Rate for Payer: BCBS MAPPO |
$131.93
|
| Rate for Payer: BCN Commercial |
$215.63
|
| Rate for Payer: BCN Medicare Advantage |
$131.93
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cash Price |
$568.00
|
| Rate for Payer: Cofinity Commercial |
$189.98
|
| Rate for Payer: Cofinity Commercial |
$176.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.93
|
| Rate for Payer: Healthscope Commercial |
$158.32
|
| Rate for Payer: Healthscope Whirlpool |
$158.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.53
|
| Rate for Payer: Meridian Medicaid |
$89.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.12
|
| Rate for Payer: Nomi Health Commercial |
$158.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$532.50
|
| Rate for Payer: PACE SWMI |
$131.93
|
| Rate for Payer: PHP Medicare Advantage |
$131.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$203.06
|
| Rate for Payer: Priority Health Medicare |
$131.93
|
| Rate for Payer: Priority Health Narrow Network |
$203.06
|
| Rate for Payer: Railroad Medicare Medicare |
$131.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$259.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$131.93
|
| Rate for Payer: UHC Exchange |
$259.80
|
| Rate for Payer: UHC Medicaid |
$84.99
|
| Rate for Payer: UHCCP DNSP |
$131.93
|
| Rate for Payer: UHCCP Medicaid |
$84.99
|
|
|
PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ
|
Professional
|
Both
|
$632.00
|
|
|
Service Code
|
HCPCS 31646
|
| Min. Negotiated Rate |
$82.22 |
| Max. Negotiated Rate |
$474.00 |
| Rate for Payer: Aetna Commercial |
$170.89
|
| Rate for Payer: Aetna Medicare |
$127.53
|
| Rate for Payer: BCBS Complete |
$86.33
|
| Rate for Payer: BCBS MAPPO |
$127.53
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Medicare Advantage |
$127.53
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cash Price |
$505.60
|
| Rate for Payer: Cofinity Commercial |
$183.64
|
| Rate for Payer: Cofinity Commercial |
$170.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.53
|
| Rate for Payer: Healthscope Commercial |
$153.04
|
| Rate for Payer: Healthscope Whirlpool |
$153.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.91
|
| Rate for Payer: Meridian Medicaid |
$86.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$140.28
|
| Rate for Payer: Nomi Health Commercial |
$153.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$474.00
|
| Rate for Payer: PACE SWMI |
$127.53
|
| Rate for Payer: PHP Medicare Advantage |
$127.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$196.97
|
| Rate for Payer: Priority Health Medicare |
$127.53
|
| Rate for Payer: Priority Health Narrow Network |
$196.97
|
| Rate for Payer: Railroad Medicare Medicare |
$127.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$250.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$127.53
|
| Rate for Payer: UHC Exchange |
$250.54
|
| Rate for Payer: UHC Medicaid |
$82.22
|
| Rate for Payer: UHCCP DNSP |
$127.53
|
| Rate for Payer: UHCCP Medicaid |
$82.22
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE
|
Professional
|
Both
|
$783.00
|
|
|
Service Code
|
HCPCS 31628
|
| Min. Negotiated Rate |
$101.18 |
| Max. Negotiated Rate |
$587.25 |
| Rate for Payer: Aetna Commercial |
$210.77
|
| Rate for Payer: Aetna Medicare |
$157.29
|
| Rate for Payer: BCBS Complete |
$106.24
|
| Rate for Payer: BCBS MAPPO |
$157.29
|
| Rate for Payer: BCN Commercial |
$281.74
|
| Rate for Payer: BCN Medicare Advantage |
$157.29
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cofinity Commercial |
$226.50
|
| Rate for Payer: Cofinity Commercial |
$210.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.29
|
| Rate for Payer: Healthscope Commercial |
$188.75
|
| Rate for Payer: Healthscope Whirlpool |
$188.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.15
|
| Rate for Payer: Meridian Medicaid |
$106.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$173.02
|
| Rate for Payer: Nomi Health Commercial |
$188.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$587.25
|
| Rate for Payer: PACE SWMI |
$157.29
|
| Rate for Payer: PHP Medicare Advantage |
$157.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$241.50
|
| Rate for Payer: Priority Health Medicare |
$157.29
|
| Rate for Payer: Priority Health Narrow Network |
$241.50
|
| Rate for Payer: Railroad Medicare Medicare |
$157.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$311.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$157.29
|
| Rate for Payer: UHC Exchange |
$311.11
|
| Rate for Payer: UHC Medicaid |
$101.18
|
| Rate for Payer: UHCCP DNSP |
$157.29
|
| Rate for Payer: UHCCP Medicaid |
$101.18
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 31632
|
| Min. Negotiated Rate |
$27.48 |
| Max. Negotiated Rate |
$99.75 |
| Rate for Payer: Aetna Commercial |
$57.38
|
| Rate for Payer: Aetna Medicare |
$42.82
|
| Rate for Payer: BCBS Complete |
$28.85
|
| Rate for Payer: BCBS MAPPO |
$42.82
|
| Rate for Payer: BCN Commercial |
$70.71
|
| Rate for Payer: BCN Medicare Advantage |
$42.82
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cofinity Commercial |
$61.66
|
| Rate for Payer: Cofinity Commercial |
$57.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.82
|
| Rate for Payer: Healthscope Commercial |
$51.38
|
| Rate for Payer: Healthscope Whirlpool |
$51.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.96
|
| Rate for Payer: Meridian Medicaid |
$28.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.10
|
| Rate for Payer: Nomi Health Commercial |
$51.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.75
|
| Rate for Payer: PACE SWMI |
$42.82
|
| Rate for Payer: PHP Medicare Advantage |
$42.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$66.59
|
| Rate for Payer: Priority Health Medicare |
$42.82
|
| Rate for Payer: Priority Health Narrow Network |
$66.59
|
| Rate for Payer: Railroad Medicare Medicare |
$42.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$88.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.82
|
| Rate for Payer: UHC Exchange |
$88.13
|
| Rate for Payer: UHC Medicaid |
$27.48
|
| Rate for Payer: UHCCP DNSP |
$42.82
|
| Rate for Payer: UHCCP Medicaid |
$27.48
|
|
|
PR BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 31633
|
| Min. Negotiated Rate |
$35.78 |
| Max. Negotiated Rate |
$112.09 |
| Rate for Payer: Aetna Commercial |
$74.84
|
| Rate for Payer: Aetna Medicare |
$55.85
|
| Rate for Payer: BCBS Complete |
$37.57
|
| Rate for Payer: BCBS MAPPO |
$55.85
|
| Rate for Payer: BCN Commercial |
$92.13
|
| Rate for Payer: BCN Medicare Advantage |
$55.85
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$74.84
|
| Rate for Payer: Cofinity Commercial |
$80.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.85
|
| Rate for Payer: Healthscope Commercial |
$67.02
|
| Rate for Payer: Healthscope Whirlpool |
$67.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.64
|
| Rate for Payer: Meridian Medicaid |
$37.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.44
|
| Rate for Payer: Nomi Health Commercial |
$67.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.50
|
| Rate for Payer: PACE SWMI |
$55.85
|
| Rate for Payer: PHP Medicare Advantage |
$55.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$86.75
|
| Rate for Payer: Priority Health Medicare |
$55.85
|
| Rate for Payer: Priority Health Narrow Network |
$86.75
|
| Rate for Payer: Railroad Medicare Medicare |
$55.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$112.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$55.85
|
| Rate for Payer: UHC Exchange |
$112.09
|
| Rate for Payer: UHC Medicaid |
$35.78
|
| Rate for Payer: UHCCP DNSP |
$55.85
|
| Rate for Payer: UHCCP Medicaid |
$35.78
|
|
|
PR BROWLIFT
|
Professional
|
Both
|
$3,605.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,442.00 |
| Max. Negotiated Rate |
$2,703.75 |
| Rate for Payer: BCBS Complete |
$1,442.00
|
| Rate for Payer: Cash Price |
$2,884.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,703.75
|
|
|
PR BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY
|
Professional
|
Both
|
$6,173.00
|
|
|
Service Code
|
HCPCS 58954
|
| Min. Negotiated Rate |
$1,272.04 |
| Max. Negotiated Rate |
$4,629.75 |
| Rate for Payer: Aetna Commercial |
$2,657.11
|
| Rate for Payer: Aetna Medicare |
$1,982.92
|
| Rate for Payer: BCBS Complete |
$1,335.64
|
| Rate for Payer: BCBS MAPPO |
$1,982.92
|
| Rate for Payer: BCN Commercial |
$3,250.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,982.92
|
| Rate for Payer: Cash Price |
$4,938.40
|
| Rate for Payer: Cash Price |
$4,938.40
|
| Rate for Payer: Cofinity Commercial |
$2,855.40
|
| Rate for Payer: Cofinity Commercial |
$2,657.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,982.92
|
| Rate for Payer: Healthscope Commercial |
$2,379.50
|
| Rate for Payer: Healthscope Whirlpool |
$2,379.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,082.07
|
| Rate for Payer: Meridian Medicaid |
$1,335.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,181.21
|
| Rate for Payer: Nomi Health Commercial |
$2,379.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,629.75
|
| Rate for Payer: PACE SWMI |
$1,982.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,982.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,272.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,292.38
|
| Rate for Payer: Priority Health Medicare |
$1,982.92
|
| Rate for Payer: Priority Health Narrow Network |
$3,292.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,982.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,816.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,982.92
|
| Rate for Payer: UHC Exchange |
$3,816.27
|
| Rate for Payer: UHC Medicaid |
$1,272.04
|
| Rate for Payer: UHCCP DNSP |
$1,982.92
|
| Rate for Payer: UHCCP Medicaid |
$1,272.04
|
|
|
PR BSO W/OMENTECTOMY TAH&RAD DEBULKING DISSECTION
|
Professional
|
Both
|
$5,397.00
|
|
|
Service Code
|
HCPCS 58953
|
| Min. Negotiated Rate |
$1,176.83 |
| Max. Negotiated Rate |
$4,047.75 |
| Rate for Payer: Aetna Commercial |
$2,457.28
|
| Rate for Payer: Aetna Medicare |
$1,833.79
|
| Rate for Payer: BCBS Complete |
$1,235.67
|
| Rate for Payer: BCBS MAPPO |
$1,833.79
|
| Rate for Payer: BCN Commercial |
$3,003.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,833.79
|
| Rate for Payer: Cash Price |
$4,317.60
|
| Rate for Payer: Cash Price |
$4,317.60
|
| Rate for Payer: Cofinity Commercial |
$2,640.66
|
| Rate for Payer: Cofinity Commercial |
$2,457.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,833.79
|
| Rate for Payer: Healthscope Commercial |
$2,200.55
|
| Rate for Payer: Healthscope Whirlpool |
$2,200.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,925.48
|
| Rate for Payer: Meridian Medicaid |
$1,235.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,017.17
|
| Rate for Payer: Nomi Health Commercial |
$2,200.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,047.75
|
| Rate for Payer: PACE SWMI |
$1,833.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,833.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,176.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,042.22
|
| Rate for Payer: Priority Health Medicare |
$1,833.79
|
| Rate for Payer: Priority Health Narrow Network |
$3,042.22
|
| Rate for Payer: Railroad Medicare Medicare |
$1,833.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,520.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,833.79
|
| Rate for Payer: UHC Exchange |
$3,520.77
|
| Rate for Payer: UHC Medicaid |
$1,176.83
|
| Rate for Payer: UHCCP DNSP |
$1,833.79
|
| Rate for Payer: UHCCP Medicaid |
$1,176.83
|
|
