|
PR CAST SUP LNG LEG SPLNT PED F
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS Q4044
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$31.36 |
| Rate for Payer: Aetna Commercial |
$29.19
|
| Rate for Payer: Aetna Medicare |
$21.78
|
| Rate for Payer: BCBS MAPPO |
$21.78
|
| Rate for Payer: BCN Commercial |
$20.85
|
| Rate for Payer: BCN Medicare Advantage |
$21.78
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$31.36
|
| Rate for Payer: Cofinity Commercial |
$29.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.78
|
| Rate for Payer: Healthscope Commercial |
$26.14
|
| Rate for Payer: Healthscope Whirlpool |
$26.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.96
|
| Rate for Payer: Nomi Health Commercial |
$26.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.00
|
| Rate for Payer: PACE SWMI |
$21.78
|
| Rate for Payer: PHP Medicare Advantage |
$21.78
|
| Rate for Payer: Priority Health Medicare |
$21.78
|
| Rate for Payer: Railroad Medicare Medicare |
$21.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.78
|
| Rate for Payer: UHC Exchange |
$7.10
|
| Rate for Payer: UHCCP DNSP |
$21.78
|
|
|
PR CAST SUP LONG ARM ADULT FBRG
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS Q4006
|
| Min. Negotiated Rate |
$12.13 |
| Max. Negotiated Rate |
$53.57 |
| Rate for Payer: Aetna Commercial |
$49.85
|
| Rate for Payer: Aetna Medicare |
$37.20
|
| Rate for Payer: BCBS MAPPO |
$37.20
|
| Rate for Payer: BCN Commercial |
$35.62
|
| Rate for Payer: BCN Medicare Advantage |
$37.20
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$53.57
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.20
|
| Rate for Payer: Healthscope Commercial |
$44.64
|
| Rate for Payer: Healthscope Whirlpool |
$44.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.92
|
| Rate for Payer: Nomi Health Commercial |
$44.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.50
|
| Rate for Payer: PACE SWMI |
$37.20
|
| Rate for Payer: PHP Medicare Advantage |
$37.20
|
| Rate for Payer: Priority Health Medicare |
$37.20
|
| Rate for Payer: Railroad Medicare Medicare |
$37.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.20
|
| Rate for Payer: UHC Exchange |
$12.13
|
| Rate for Payer: UHCCP DNSP |
$37.20
|
|
|
PR CAST SUP LONG ARM PED FBRGLS
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS Q4008
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$26.77 |
| Rate for Payer: Aetna Commercial |
$24.91
|
| Rate for Payer: Aetna Medicare |
$18.59
|
| Rate for Payer: BCBS MAPPO |
$18.59
|
| Rate for Payer: BCN Commercial |
$17.80
|
| Rate for Payer: BCN Medicare Advantage |
$18.59
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$26.77
|
| Rate for Payer: Cofinity Commercial |
$24.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.59
|
| Rate for Payer: Healthscope Commercial |
$22.31
|
| Rate for Payer: Healthscope Whirlpool |
$22.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.45
|
| Rate for Payer: Nomi Health Commercial |
$22.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: PACE SWMI |
$18.59
|
| Rate for Payer: PHP Medicare Advantage |
$18.59
|
| Rate for Payer: Priority Health Medicare |
$18.59
|
| Rate for Payer: Railroad Medicare Medicare |
$18.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.59
|
| Rate for Payer: UHC Exchange |
$6.06
|
| Rate for Payer: UHCCP DNSP |
$18.59
|
|
|
PR CAST SUP LONG LEG FIBERGLASS
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS Q4030
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$139.56 |
| Rate for Payer: Aetna Commercial |
$129.87
|
| Rate for Payer: Aetna Medicare |
$96.92
|
| Rate for Payer: BCBS MAPPO |
$96.92
|
| Rate for Payer: BCN Commercial |
$92.79
|
| Rate for Payer: BCN Medicare Advantage |
$96.92
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$139.56
|
| Rate for Payer: Cofinity Commercial |
$129.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.92
|
| Rate for Payer: Healthscope Commercial |
$116.30
|
| Rate for Payer: Healthscope Whirlpool |
$116.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$106.61
|
| Rate for Payer: Nomi Health Commercial |
$116.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.25
|
| Rate for Payer: PACE SWMI |
$96.92
|
| Rate for Payer: PHP Medicare Advantage |
$96.92
|
| Rate for Payer: Priority Health Medicare |
$96.92
|
| Rate for Payer: Railroad Medicare Medicare |
$96.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$96.92
|
| Rate for Payer: UHC Exchange |
$31.60
|
| Rate for Payer: UHCCP DNSP |
$96.92
|
|
|
PR CAST SUPPLIES UNLISTED
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS Q4050
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$78.75 |
| Rate for Payer: BCN Commercial |
$25.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
|
|
PR CAST SUP SHOULDER CAST FBRGL
|
Professional
|
Both
|
$159.00
|
|
|
Service Code
|
HCPCS Q4004
|
| Min. Negotiated Rate |
$50.55 |
| Max. Negotiated Rate |
$223.24 |
| Rate for Payer: Aetna Commercial |
$207.74
|
| Rate for Payer: Aetna Medicare |
$155.03
|
| Rate for Payer: BCBS MAPPO |
$155.03
|
| Rate for Payer: BCN Commercial |
$148.43
|
| Rate for Payer: BCN Medicare Advantage |
$155.03
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cash Price |
$127.20
|
| Rate for Payer: Cofinity Commercial |
$223.24
|
| Rate for Payer: Cofinity Commercial |
$207.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.03
|
| Rate for Payer: Healthscope Commercial |
$186.04
|
| Rate for Payer: Healthscope Whirlpool |
$186.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$170.53
|
| Rate for Payer: Nomi Health Commercial |
$186.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.25
|
| Rate for Payer: PACE SWMI |
$155.03
|
| Rate for Payer: PHP Medicare Advantage |
$155.03
|
| Rate for Payer: Priority Health Medicare |
$155.03
|
| Rate for Payer: Railroad Medicare Medicare |
$155.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$155.03
|
| Rate for Payer: UHC Exchange |
$50.55
|
| Rate for Payer: UHCCP DNSP |
$155.03
|
|
|
PR CAST SUP SHRT LEG FIBERGLASS
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS Q4038
|
| Min. Negotiated Rate |
$17.11 |
| Max. Negotiated Rate |
$75.57 |
| Rate for Payer: Aetna Commercial |
$70.32
|
| Rate for Payer: Aetna Medicare |
$52.48
|
| Rate for Payer: BCBS MAPPO |
$52.48
|
| Rate for Payer: BCN Commercial |
$50.24
|
| Rate for Payer: BCN Medicare Advantage |
$52.48
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$70.32
|
| Rate for Payer: Cofinity Commercial |
$75.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.48
|
| Rate for Payer: Healthscope Commercial |
$62.98
|
| Rate for Payer: Healthscope Whirlpool |
$62.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.73
|
| Rate for Payer: Nomi Health Commercial |
$62.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
| Rate for Payer: PACE SWMI |
$52.48
|
| Rate for Payer: PHP Medicare Advantage |
$52.48
|
| Rate for Payer: Priority Health Medicare |
$52.48
|
| Rate for Payer: Railroad Medicare Medicare |
$52.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$17.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.48
|
| Rate for Payer: UHC Exchange |
$17.11
|
| Rate for Payer: UHCCP DNSP |
$52.48
|
|
|
PR CAST SUP SHRT LEG PED FBRGLS
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
HCPCS Q4040
|
| Min. Negotiated Rate |
$8.56 |
| Max. Negotiated Rate |
$37.77 |
| Rate for Payer: Aetna Commercial |
$35.15
|
| Rate for Payer: Aetna Medicare |
$26.23
|
| Rate for Payer: BCBS MAPPO |
$26.23
|
| Rate for Payer: BCN Commercial |
$25.12
|
| Rate for Payer: BCN Medicare Advantage |
$26.23
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$37.77
|
| Rate for Payer: Cofinity Commercial |
$35.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.23
|
| Rate for Payer: Healthscope Commercial |
$31.48
|
| Rate for Payer: Healthscope Whirlpool |
$31.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.85
|
| Rate for Payer: Nomi Health Commercial |
$31.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.50
|
| Rate for Payer: PACE SWMI |
$26.23
|
| Rate for Payer: PHP Medicare Advantage |
$26.23
|
| Rate for Payer: Priority Health Medicare |
$26.23
|
| Rate for Payer: Railroad Medicare Medicare |
$26.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.23
|
| Rate for Payer: UHC Exchange |
$8.56
|
| Rate for Payer: UHCCP DNSP |
$26.23
|
|
|
PR CAST SUP SHT ARM ADULT FBRGL
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS Q4010
|
| Min. Negotiated Rate |
$8.09 |
| Max. Negotiated Rate |
$35.71 |
| Rate for Payer: Aetna Commercial |
$33.23
|
| Rate for Payer: Aetna Medicare |
$24.80
|
| Rate for Payer: BCBS MAPPO |
$24.80
|
| Rate for Payer: BCN Commercial |
$23.74
|
| Rate for Payer: BCN Medicare Advantage |
$24.80
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$35.71
|
| Rate for Payer: Cofinity Commercial |
$33.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.80
|
| Rate for Payer: Healthscope Commercial |
$29.76
|
| Rate for Payer: Healthscope Whirlpool |
$29.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.28
|
| Rate for Payer: Nomi Health Commercial |
$29.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$24.80
|
| Rate for Payer: PHP Medicare Advantage |
$24.80
|
| Rate for Payer: Priority Health Medicare |
$24.80
|
| Rate for Payer: Railroad Medicare Medicare |
$24.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$8.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.80
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHCCP DNSP |
$24.80
|
|
|
PR CAST SUP SHT ARM ADULT PLSTR
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS Q4009
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$15.88 |
| Rate for Payer: Aetna Commercial |
$14.78
|
| Rate for Payer: Aetna Medicare |
$11.03
|
| Rate for Payer: BCBS MAPPO |
$11.03
|
| Rate for Payer: BCN Commercial |
$10.56
|
| Rate for Payer: BCN Medicare Advantage |
$11.03
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$15.88
|
| Rate for Payer: Cofinity Commercial |
$14.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.03
|
| Rate for Payer: Healthscope Commercial |
$13.24
|
| Rate for Payer: Healthscope Whirlpool |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.13
|
| Rate for Payer: Nomi Health Commercial |
$13.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.25
|
| Rate for Payer: PACE SWMI |
$11.03
|
| Rate for Payer: PHP Medicare Advantage |
$11.03
|
| Rate for Payer: Priority Health Medicare |
$11.03
|
| Rate for Payer: Railroad Medicare Medicare |
$11.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.03
|
| Rate for Payer: UHC Exchange |
$3.60
|
| Rate for Payer: UHCCP DNSP |
$11.03
|
|
|
PR CAST SUP SHT ARM PED FBRGLAS
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS Q4012
|
| Min. Negotiated Rate |
$4.05 |
| Max. Negotiated Rate |
$17.90 |
| Rate for Payer: Aetna Commercial |
$16.66
|
| Rate for Payer: Aetna Medicare |
$12.43
|
| Rate for Payer: BCBS MAPPO |
$12.43
|
| Rate for Payer: BCN Commercial |
$11.90
|
| Rate for Payer: BCN Medicare Advantage |
$12.43
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$16.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.43
|
| Rate for Payer: Healthscope Commercial |
$14.92
|
| Rate for Payer: Healthscope Whirlpool |
$14.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.67
|
| Rate for Payer: Nomi Health Commercial |
$14.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: PACE SWMI |
$12.43
|
| Rate for Payer: PHP Medicare Advantage |
$12.43
|
| Rate for Payer: Priority Health Medicare |
$12.43
|
| Rate for Payer: Railroad Medicare Medicare |
$12.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.43
|
| Rate for Payer: UHC Exchange |
$4.05
|
| Rate for Payer: UHCCP DNSP |
$12.43
|
|
|
PR CAST SUP SHT ARM SPLINT FBRG
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS Q4022
|
| Min. Negotiated Rate |
$5.05 |
| Max. Negotiated Rate |
$22.32 |
| Rate for Payer: Aetna Commercial |
$20.77
|
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCN Commercial |
$14.84
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$22.32
|
| Rate for Payer: Cofinity Commercial |
$20.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$18.60
|
| Rate for Payer: Healthscope Whirlpool |
$18.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.05
|
| Rate for Payer: Nomi Health Commercial |
$18.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: PACE SWMI |
$15.50
|
| Rate for Payer: PHP Medicare Advantage |
$15.50
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.50
|
| Rate for Payer: UHC Exchange |
$5.05
|
| Rate for Payer: UHCCP DNSP |
$15.50
|
|
|
PR CAST SUP SHT ARM SPLINT PLST
|
Professional
|
Both
|
$9.00
|
|
|
Service Code
|
HCPCS Q4021
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$12.37 |
| Rate for Payer: Aetna Commercial |
$11.51
|
| Rate for Payer: Aetna Medicare |
$8.59
|
| Rate for Payer: BCBS MAPPO |
$8.59
|
| Rate for Payer: BCN Commercial |
$8.22
|
| Rate for Payer: BCN Medicare Advantage |
$8.59
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cofinity Commercial |
$12.37
|
| Rate for Payer: Cofinity Commercial |
$11.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.59
|
| Rate for Payer: Healthscope Commercial |
$10.31
|
| Rate for Payer: Healthscope Whirlpool |
$10.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.45
|
| Rate for Payer: Nomi Health Commercial |
$10.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.75
|
| Rate for Payer: PACE SWMI |
$8.59
|
| Rate for Payer: PHP Medicare Advantage |
$8.59
|
| Rate for Payer: Priority Health Medicare |
$8.59
|
| Rate for Payer: Railroad Medicare Medicare |
$8.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.59
|
| Rate for Payer: UHC Exchange |
$2.80
|
| Rate for Payer: UHCCP DNSP |
$8.59
|
|
|
PR CAST SUP SHT ARM SPLNT PED F
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS Q4024
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$21.75 |
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: Aetna Medicare |
$7.76
|
| Rate for Payer: BCBS MAPPO |
$7.76
|
| Rate for Payer: BCN Commercial |
$7.43
|
| Rate for Payer: BCN Medicare Advantage |
$7.76
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Commercial |
$11.17
|
| Rate for Payer: Cofinity Commercial |
$10.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.76
|
| Rate for Payer: Healthscope Commercial |
$9.31
|
| Rate for Payer: Healthscope Whirlpool |
$9.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.54
|
| Rate for Payer: Nomi Health Commercial |
$9.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
| Rate for Payer: PACE SWMI |
$7.76
|
| Rate for Payer: PHP Medicare Advantage |
$7.76
|
| Rate for Payer: Priority Health Medicare |
$7.76
|
| Rate for Payer: Railroad Medicare Medicare |
$7.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.76
|
| Rate for Payer: UHC Exchange |
$2.53
|
| Rate for Payer: UHCCP DNSP |
$7.76
|
|
|
PR CAST SUP SHT ARM SPLNT PED P
|
Professional
|
Both
|
$16.00
|
|
|
Service Code
|
HCPCS Q4023
|
| Min. Negotiated Rate |
$1.41 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: Aetna Commercial |
$5.78
|
| Rate for Payer: Aetna Medicare |
$4.31
|
| Rate for Payer: BCBS MAPPO |
$4.31
|
| Rate for Payer: BCN Commercial |
$4.13
|
| Rate for Payer: BCN Medicare Advantage |
$4.31
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cofinity Commercial |
$6.21
|
| Rate for Payer: Cofinity Commercial |
$5.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.31
|
| Rate for Payer: Healthscope Commercial |
$5.17
|
| Rate for Payer: Healthscope Whirlpool |
$5.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.74
|
| Rate for Payer: Nomi Health Commercial |
$5.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.00
|
| Rate for Payer: PACE SWMI |
$4.31
|
| Rate for Payer: PHP Medicare Advantage |
$4.31
|
| Rate for Payer: Priority Health Medicare |
$4.31
|
| Rate for Payer: Railroad Medicare Medicare |
$4.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.31
|
| Rate for Payer: UHC Exchange |
$1.41
|
| Rate for Payer: UHCCP DNSP |
$4.31
|
|
|
PR CAST SUP SHT LEG SPLNT FBRGL
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS Q4046
|
| Min. Negotiated Rate |
$7.75 |
| Max. Negotiated Rate |
$34.26 |
| Rate for Payer: Aetna Commercial |
$31.88
|
| Rate for Payer: Aetna Medicare |
$23.79
|
| Rate for Payer: BCBS MAPPO |
$23.79
|
| Rate for Payer: BCN Commercial |
$22.77
|
| Rate for Payer: BCN Medicare Advantage |
$23.79
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$34.26
|
| Rate for Payer: Cofinity Commercial |
$31.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.79
|
| Rate for Payer: Healthscope Commercial |
$28.55
|
| Rate for Payer: Healthscope Whirlpool |
$28.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.17
|
| Rate for Payer: Nomi Health Commercial |
$28.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
| Rate for Payer: PACE SWMI |
$23.79
|
| Rate for Payer: PHP Medicare Advantage |
$23.79
|
| Rate for Payer: Priority Health Medicare |
$23.79
|
| Rate for Payer: Railroad Medicare Medicare |
$23.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.79
|
| Rate for Payer: UHC Exchange |
$7.75
|
| Rate for Payer: UHCCP DNSP |
$23.79
|
|
|
PR CAST SUP SHT LEG SPLNT PED F
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS Q4048
|
| Min. Negotiated Rate |
$3.88 |
| Max. Negotiated Rate |
$20.25 |
| Rate for Payer: Aetna Commercial |
$15.95
|
| Rate for Payer: Aetna Medicare |
$11.90
|
| Rate for Payer: BCBS MAPPO |
$11.90
|
| Rate for Payer: BCN Commercial |
$11.40
|
| Rate for Payer: BCN Medicare Advantage |
$11.90
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$15.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.90
|
| Rate for Payer: Healthscope Commercial |
$14.28
|
| Rate for Payer: Healthscope Whirlpool |
$14.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.09
|
| Rate for Payer: Nomi Health Commercial |
$14.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: PACE SWMI |
$11.90
|
| Rate for Payer: PHP Medicare Advantage |
$11.90
|
| Rate for Payer: Priority Health Medicare |
$11.90
|
| Rate for Payer: Railroad Medicare Medicare |
$11.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.90
|
| Rate for Payer: UHC Exchange |
$3.88
|
| Rate for Payer: UHCCP DNSP |
$11.90
|
|
|
PR CAST SUP SHT LEG SPLNT PED P
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS Q4047
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Aetna Commercial |
$9.86
|
| Rate for Payer: Aetna Medicare |
$7.36
|
| Rate for Payer: BCBS MAPPO |
$7.36
|
| Rate for Payer: BCN Commercial |
$7.05
|
| Rate for Payer: BCN Medicare Advantage |
$7.36
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$10.60
|
| Rate for Payer: Cofinity Commercial |
$9.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.36
|
| Rate for Payer: Healthscope Commercial |
$8.83
|
| Rate for Payer: Healthscope Whirlpool |
$8.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.10
|
| Rate for Payer: Nomi Health Commercial |
$8.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: PACE SWMI |
$7.36
|
| Rate for Payer: PHP Medicare Advantage |
$7.36
|
| Rate for Payer: Priority Health Medicare |
$7.36
|
| Rate for Payer: Railroad Medicare Medicare |
$7.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.36
|
| Rate for Payer: UHC Exchange |
$2.40
|
| Rate for Payer: UHCCP DNSP |
$7.36
|
|
|
PR CATHETER ASPIRATION NASOTRACHEAL SPX
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 31720
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$97.60 |
| Rate for Payer: Aetna Commercial |
$60.46
|
| Rate for Payer: Aetna Medicare |
$45.12
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS MAPPO |
$45.12
|
| Rate for Payer: BCN Commercial |
$79.18
|
| Rate for Payer: BCN Medicare Advantage |
$45.12
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$64.97
|
| Rate for Payer: Cofinity Commercial |
$60.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.12
|
| Rate for Payer: Healthscope Commercial |
$54.14
|
| Rate for Payer: Healthscope Whirlpool |
$54.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.38
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.63
|
| Rate for Payer: Nomi Health Commercial |
$54.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.50
|
| Rate for Payer: PACE SWMI |
$45.12
|
| Rate for Payer: PHP Medicare Advantage |
$45.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$74.56
|
| Rate for Payer: Priority Health Medicare |
$45.12
|
| Rate for Payer: Priority Health Narrow Network |
$74.56
|
| Rate for Payer: Railroad Medicare Medicare |
$45.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$97.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$45.12
|
| Rate for Payer: UHC Exchange |
$97.60
|
| Rate for Payer: UHC Medicaid |
$28.97
|
| Rate for Payer: UHCCP DNSP |
$45.12
|
| Rate for Payer: UHCCP Medicaid |
$28.97
|
|
|
PR CATHETERIZATION UMBILICAL NEWBORN ART DX/THERAPY
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 36660
|
| Min. Negotiated Rate |
$36.64 |
| Max. Negotiated Rate |
$121.14 |
| Rate for Payer: Aetna Commercial |
$76.30
|
| Rate for Payer: Aetna Medicare |
$56.94
|
| Rate for Payer: BCBS Complete |
$38.47
|
| Rate for Payer: BCBS MAPPO |
$56.94
|
| Rate for Payer: BCN Commercial |
$100.09
|
| Rate for Payer: BCN Medicare Advantage |
$56.94
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cofinity Commercial |
$81.99
|
| Rate for Payer: Cofinity Commercial |
$76.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.94
|
| Rate for Payer: Healthscope Commercial |
$68.33
|
| Rate for Payer: Healthscope Whirlpool |
$68.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.79
|
| Rate for Payer: Meridian Medicaid |
$38.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.63
|
| Rate for Payer: Nomi Health Commercial |
$68.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$108.75
|
| Rate for Payer: PACE SWMI |
$56.94
|
| Rate for Payer: PHP Medicare Advantage |
$56.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$107.64
|
| Rate for Payer: Priority Health Medicare |
$56.94
|
| Rate for Payer: Priority Health Narrow Network |
$107.64
|
| Rate for Payer: Railroad Medicare Medicare |
$56.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$121.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$56.94
|
| Rate for Payer: UHC Exchange |
$121.14
|
| Rate for Payer: UHC Medicaid |
$36.64
|
| Rate for Payer: UHCCP DNSP |
$56.94
|
| Rate for Payer: UHCCP Medicaid |
$36.64
|
|
|
PR CATHETERIZATION W/BRONCHIAL BRUSH BIOPSY
|
Professional
|
Both
|
$546.00
|
|
|
Service Code
|
HCPCS 31717
|
| Min. Negotiated Rate |
$61.56 |
| Max. Negotiated Rate |
$409.50 |
| Rate for Payer: Aetna Commercial |
$127.89
|
| Rate for Payer: Aetna Medicare |
$95.44
|
| Rate for Payer: BCBS Complete |
$64.64
|
| Rate for Payer: BCBS MAPPO |
$95.44
|
| Rate for Payer: BCN Commercial |
$154.87
|
| Rate for Payer: BCN Medicare Advantage |
$95.44
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cash Price |
$436.80
|
| Rate for Payer: Cofinity Commercial |
$137.43
|
| Rate for Payer: Cofinity Commercial |
$127.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.44
|
| Rate for Payer: Healthscope Commercial |
$114.53
|
| Rate for Payer: Healthscope Whirlpool |
$114.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.21
|
| Rate for Payer: Meridian Medicaid |
$64.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.98
|
| Rate for Payer: Nomi Health Commercial |
$114.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.50
|
| Rate for Payer: PACE SWMI |
$95.44
|
| Rate for Payer: PHP Medicare Advantage |
$95.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$145.85
|
| Rate for Payer: Priority Health Medicare |
$95.44
|
| Rate for Payer: Priority Health Narrow Network |
$145.85
|
| Rate for Payer: Railroad Medicare Medicare |
$95.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.44
|
| Rate for Payer: UHC Exchange |
$187.36
|
| Rate for Payer: UHC Medicaid |
$61.56
|
| Rate for Payer: UHCCP DNSP |
$95.44
|
| Rate for Payer: UHCCP Medicaid |
$61.56
|
|
|
PR CATHETERIZE FOR URINE SPEC
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS P9612
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$23.25 |
| Rate for Payer: Aetna Commercial |
$12.52
|
| Rate for Payer: Aetna Medicare |
$9.34
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$9.34
|
| Rate for Payer: BCN Commercial |
$6.38
|
| Rate for Payer: BCN Medicare Advantage |
$9.34
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$13.45
|
| Rate for Payer: Cofinity Commercial |
$12.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.34
|
| Rate for Payer: Healthscope Commercial |
$11.21
|
| Rate for Payer: Healthscope Whirlpool |
$11.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.27
|
| Rate for Payer: Nomi Health Commercial |
$11.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.25
|
| Rate for Payer: PACE SWMI |
$9.34
|
| Rate for Payer: PHP Medicare Advantage |
$9.34
|
| Rate for Payer: Priority Health Medicare |
$9.34
|
| Rate for Payer: Railroad Medicare Medicare |
$9.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.34
|
| Rate for Payer: UHC Exchange |
$1.26
|
| Rate for Payer: UHCCP DNSP |
$9.34
|
|
|
PR CATHJ UMBILICAL VEIN DX/THER NB
|
Professional
|
Both
|
$298.00
|
|
|
Service Code
|
HCPCS 36510
|
| Min. Negotiated Rate |
$28.76 |
| Max. Negotiated Rate |
$223.50 |
| Rate for Payer: Aetna Commercial |
$59.97
|
| Rate for Payer: Aetna Medicare |
$44.75
|
| Rate for Payer: BCBS Complete |
$30.20
|
| Rate for Payer: BCBS MAPPO |
$44.75
|
| Rate for Payer: BCN Commercial |
$77.18
|
| Rate for Payer: BCN Medicare Advantage |
$44.75
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Cofinity Commercial |
$64.44
|
| Rate for Payer: Cofinity Commercial |
$59.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.75
|
| Rate for Payer: Healthscope Commercial |
$53.70
|
| Rate for Payer: Healthscope Whirlpool |
$53.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.99
|
| Rate for Payer: Meridian Medicaid |
$30.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.23
|
| Rate for Payer: Nomi Health Commercial |
$53.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.50
|
| Rate for Payer: PACE SWMI |
$44.75
|
| Rate for Payer: PHP Medicare Advantage |
$44.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$83.01
|
| Rate for Payer: Priority Health Medicare |
$44.75
|
| Rate for Payer: Priority Health Narrow Network |
$83.01
|
| Rate for Payer: Railroad Medicare Medicare |
$44.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$44.75
|
| Rate for Payer: UHC Exchange |
$95.30
|
| Rate for Payer: UHC Medicaid |
$28.76
|
| Rate for Payer: UHCCP DNSP |
$44.75
|
| Rate for Payer: UHCCP Medicaid |
$28.76
|
|
|
PR CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I
|
Professional
|
Both
|
$1,764.00
|
|
|
Service Code
|
HCPCS 93454
|
| Min. Negotiated Rate |
$820.92 |
| Max. Negotiated Rate |
$1,407.38 |
| Rate for Payer: Aetna Commercial |
$1,100.03
|
| Rate for Payer: Aetna Commercial |
$1,100.03
|
| Rate for Payer: Aetna Medicare |
$820.92
|
| Rate for Payer: Aetna Medicare |
$820.92
|
| Rate for Payer: BCBS MAPPO |
$820.92
|
| Rate for Payer: BCBS MAPPO |
$820.92
|
| Rate for Payer: BCN Commercial |
$1,286.78
|
| Rate for Payer: BCN Commercial |
$1,286.78
|
| Rate for Payer: BCN Medicare Advantage |
$820.92
|
| Rate for Payer: BCN Medicare Advantage |
$820.92
|
| Rate for Payer: Cash Price |
$1,411.20
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cash Price |
$1,411.20
|
| Rate for Payer: Cash Price |
$644.00
|
| Rate for Payer: Cofinity Commercial |
$1,100.03
|
| Rate for Payer: Cofinity Commercial |
$1,182.12
|
| Rate for Payer: Cofinity Commercial |
$1,100.03
|
| Rate for Payer: Cofinity Commercial |
$1,182.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$820.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$820.92
|
| Rate for Payer: Healthscope Commercial |
$985.10
|
| Rate for Payer: Healthscope Commercial |
$985.10
|
| Rate for Payer: Healthscope Whirlpool |
$985.10
|
| Rate for Payer: Healthscope Whirlpool |
$985.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$861.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$861.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$903.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$903.01
|
| Rate for Payer: Nomi Health Commercial |
$985.10
|
| Rate for Payer: Nomi Health Commercial |
$985.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$603.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,323.00
|
| Rate for Payer: PACE SWMI |
$820.92
|
| Rate for Payer: PACE SWMI |
$820.92
|
| Rate for Payer: PHP Medicare Advantage |
$820.92
|
| Rate for Payer: PHP Medicare Advantage |
$820.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,223.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,223.02
|
| Rate for Payer: Priority Health Medicare |
$820.92
|
| Rate for Payer: Priority Health Medicare |
$820.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,223.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,223.02
|
| Rate for Payer: Railroad Medicare Medicare |
$820.92
|
| Rate for Payer: Railroad Medicare Medicare |
$820.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,407.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,407.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$820.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$820.92
|
| Rate for Payer: UHC Exchange |
$1,407.38
|
| Rate for Payer: UHC Exchange |
$1,407.38
|
| Rate for Payer: UHCCP DNSP |
$820.92
|
| Rate for Payer: UHCCP DNSP |
$820.92
|
|
|
PR CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I
|
Professional
|
Both
|
$1,144.00
|
|
|
Service Code
|
HCPCS 93459
|
| Min. Negotiated Rate |
$858.00 |
| Max. Negotiated Rate |
$1,797.10 |
| Rate for Payer: Aetna Commercial |
$1,367.08
|
| Rate for Payer: Aetna Commercial |
$1,367.08
|
| Rate for Payer: Aetna Medicare |
$1,020.21
|
| Rate for Payer: Aetna Medicare |
$1,020.21
|
| Rate for Payer: BCBS MAPPO |
$1,020.21
|
| Rate for Payer: BCBS MAPPO |
$1,020.21
|
| Rate for Payer: BCN Commercial |
$1,596.03
|
| Rate for Payer: BCN Commercial |
$1,596.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,020.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,020.21
|
| Rate for Payer: Cash Price |
$915.20
|
| Rate for Payer: Cash Price |
$1,812.80
|
| Rate for Payer: Cash Price |
$915.20
|
| Rate for Payer: Cash Price |
$1,812.80
|
| Rate for Payer: Cofinity Commercial |
$1,367.08
|
| Rate for Payer: Cofinity Commercial |
$1,469.10
|
| Rate for Payer: Cofinity Commercial |
$1,367.08
|
| Rate for Payer: Cofinity Commercial |
$1,469.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,020.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,020.21
|
| Rate for Payer: Healthscope Commercial |
$1,224.25
|
| Rate for Payer: Healthscope Commercial |
$1,224.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,224.25
|
| Rate for Payer: Healthscope Whirlpool |
$1,224.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,071.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,071.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,122.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,122.23
|
| Rate for Payer: Nomi Health Commercial |
$1,224.25
|
| Rate for Payer: Nomi Health Commercial |
$1,224.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,699.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.00
|
| Rate for Payer: PACE SWMI |
$1,020.21
|
| Rate for Payer: PACE SWMI |
$1,020.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,020.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,020.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,516.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,516.95
|
| Rate for Payer: Priority Health Medicare |
$1,020.21
|
| Rate for Payer: Priority Health Medicare |
$1,020.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,516.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,516.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,020.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,020.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,797.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,797.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,020.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,020.21
|
| Rate for Payer: UHC Exchange |
$1,797.10
|
| Rate for Payer: UHC Exchange |
$1,797.10
|
| Rate for Payer: UHCCP DNSP |
$1,020.21
|
| Rate for Payer: UHCCP DNSP |
$1,020.21
|
|
