|
PR CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 64617
|
| Min. Negotiated Rate |
$58.58 |
| Max. Negotiated Rate |
$249.00 |
| Rate for Payer: Aetna Commercial |
$122.09
|
| Rate for Payer: Aetna Medicare |
$91.11
|
| Rate for Payer: BCBS Complete |
$61.51
|
| Rate for Payer: BCBS MAPPO |
$91.11
|
| Rate for Payer: BCN Commercial |
$162.34
|
| Rate for Payer: BCN Medicare Advantage |
$91.11
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cofinity Commercial |
$131.20
|
| Rate for Payer: Cofinity Commercial |
$122.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.11
|
| Rate for Payer: Healthscope Commercial |
$109.33
|
| Rate for Payer: Healthscope Whirlpool |
$109.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.67
|
| Rate for Payer: Meridian Medicaid |
$61.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.22
|
| Rate for Payer: Nomi Health Commercial |
$109.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.00
|
| Rate for Payer: PACE SWMI |
$91.11
|
| Rate for Payer: PHP Medicare Advantage |
$91.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$188.56
|
| Rate for Payer: Priority Health Medicare |
$91.11
|
| Rate for Payer: Priority Health Narrow Network |
$188.56
|
| Rate for Payer: Railroad Medicare Medicare |
$91.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.11
|
| Rate for Payer: UHC Exchange |
$191.42
|
| Rate for Payer: UHC Medicaid |
$58.58
|
| Rate for Payer: UHCCP DNSP |
$91.11
|
| Rate for Payer: UHCCP Medicaid |
$58.58
|
|
|
PR CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA
|
Professional
|
Both
|
$372.00
|
|
|
Service Code
|
HCPCS 64616
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$279.00 |
| Rate for Payer: Aetna Commercial |
$132.41
|
| Rate for Payer: Aetna Medicare |
$98.81
|
| Rate for Payer: BCBS Complete |
$66.64
|
| Rate for Payer: BCBS MAPPO |
$98.81
|
| Rate for Payer: BCN Commercial |
$165.83
|
| Rate for Payer: BCN Medicare Advantage |
$98.81
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cofinity Commercial |
$142.29
|
| Rate for Payer: Cofinity Commercial |
$132.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.81
|
| Rate for Payer: Healthscope Commercial |
$118.57
|
| Rate for Payer: Healthscope Whirlpool |
$118.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.75
|
| Rate for Payer: Meridian Medicaid |
$66.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.69
|
| Rate for Payer: Nomi Health Commercial |
$118.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.00
|
| Rate for Payer: PACE SWMI |
$98.81
|
| Rate for Payer: PHP Medicare Advantage |
$98.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$192.60
|
| Rate for Payer: Priority Health Medicare |
$98.81
|
| Rate for Payer: Priority Health Narrow Network |
$192.60
|
| Rate for Payer: Railroad Medicare Medicare |
$98.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$191.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.81
|
| Rate for Payer: UHC Exchange |
$191.12
|
| Rate for Payer: UHC Medicaid |
$63.47
|
| Rate for Payer: UHCCP DNSP |
$98.81
|
| Rate for Payer: UHCCP Medicaid |
$63.47
|
|
|
PR CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES
|
Professional
|
Both
|
$318.00
|
|
|
Service Code
|
HCPCS 64646
|
| Min. Negotiated Rate |
$66.24 |
| Max. Negotiated Rate |
$238.50 |
| Rate for Payer: Aetna Commercial |
$138.58
|
| Rate for Payer: Aetna Medicare |
$103.42
|
| Rate for Payer: BCBS Complete |
$69.55
|
| Rate for Payer: BCBS MAPPO |
$103.42
|
| Rate for Payer: BCN Commercial |
$175.29
|
| Rate for Payer: BCN Medicare Advantage |
$103.42
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cofinity Commercial |
$148.92
|
| Rate for Payer: Cofinity Commercial |
$138.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.42
|
| Rate for Payer: Healthscope Commercial |
$124.10
|
| Rate for Payer: Healthscope Whirlpool |
$124.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.59
|
| Rate for Payer: Meridian Medicaid |
$69.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$113.76
|
| Rate for Payer: Nomi Health Commercial |
$124.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$238.50
|
| Rate for Payer: PACE SWMI |
$103.42
|
| Rate for Payer: PHP Medicare Advantage |
$103.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$203.60
|
| Rate for Payer: Priority Health Medicare |
$103.42
|
| Rate for Payer: Priority Health Narrow Network |
$203.60
|
| Rate for Payer: Railroad Medicare Medicare |
$103.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$202.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$103.42
|
| Rate for Payer: UHC Exchange |
$202.54
|
| Rate for Payer: UHC Medicaid |
$66.24
|
| Rate for Payer: UHCCP DNSP |
$103.42
|
| Rate for Payer: UHCCP Medicaid |
$66.24
|
|
|
PR CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE
|
Professional
|
Both
|
$410.00
|
|
|
Service Code
|
HCPCS 64642
|
| Min. Negotiated Rate |
$61.34 |
| Max. Negotiated Rate |
$307.50 |
| Rate for Payer: Aetna Commercial |
$127.73
|
| Rate for Payer: Aetna Medicare |
$95.32
|
| Rate for Payer: BCBS Complete |
$64.41
|
| Rate for Payer: BCBS MAPPO |
$95.32
|
| Rate for Payer: BCN Commercial |
$160.85
|
| Rate for Payer: BCN Medicare Advantage |
$95.32
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cash Price |
$328.00
|
| Rate for Payer: Cofinity Commercial |
$137.26
|
| Rate for Payer: Cofinity Commercial |
$127.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.32
|
| Rate for Payer: Healthscope Commercial |
$114.38
|
| Rate for Payer: Healthscope Whirlpool |
$114.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.09
|
| Rate for Payer: Meridian Medicaid |
$64.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.85
|
| Rate for Payer: Nomi Health Commercial |
$114.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.50
|
| Rate for Payer: PACE SWMI |
$95.32
|
| Rate for Payer: PHP Medicare Advantage |
$95.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$186.82
|
| Rate for Payer: Priority Health Medicare |
$95.32
|
| Rate for Payer: Priority Health Narrow Network |
$186.82
|
| Rate for Payer: Railroad Medicare Medicare |
$95.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.32
|
| Rate for Payer: UHC Exchange |
$188.20
|
| Rate for Payer: UHC Medicaid |
$61.34
|
| Rate for Payer: UHCCP DNSP |
$95.32
|
| Rate for Payer: UHCCP Medicaid |
$61.34
|
|
|
PR CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 64611
|
| Min. Negotiated Rate |
$69.01 |
| Max. Negotiated Rate |
$198.39 |
| Rate for Payer: Aetna Commercial |
$140.06
|
| Rate for Payer: Aetna Medicare |
$104.52
|
| Rate for Payer: BCBS Complete |
$72.46
|
| Rate for Payer: BCBS MAPPO |
$104.52
|
| Rate for Payer: BCN Commercial |
$170.81
|
| Rate for Payer: BCN Medicare Advantage |
$104.52
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cofinity Commercial |
$150.51
|
| Rate for Payer: Cofinity Commercial |
$140.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.52
|
| Rate for Payer: Healthscope Commercial |
$125.42
|
| Rate for Payer: Healthscope Whirlpool |
$125.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.75
|
| Rate for Payer: Meridian Medicaid |
$72.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.97
|
| Rate for Payer: Nomi Health Commercial |
$125.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$165.00
|
| Rate for Payer: PACE SWMI |
$104.52
|
| Rate for Payer: PHP Medicare Advantage |
$104.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$198.39
|
| Rate for Payer: Priority Health Medicare |
$104.52
|
| Rate for Payer: Priority Health Narrow Network |
$198.39
|
| Rate for Payer: Railroad Medicare Medicare |
$104.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$180.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.52
|
| Rate for Payer: UHC Exchange |
$180.87
|
| Rate for Payer: UHC Medicaid |
$69.01
|
| Rate for Payer: UHCCP DNSP |
$104.52
|
| Rate for Payer: UHCCP Medicaid |
$69.01
|
|
|
PR CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE
|
Professional
|
Both
|
$431.00
|
|
|
Service Code
|
HCPCS 64615
|
| Min. Negotiated Rate |
$69.65 |
| Max. Negotiated Rate |
$323.25 |
| Rate for Payer: Aetna Commercial |
$146.62
|
| Rate for Payer: Aetna Medicare |
$109.42
|
| Rate for Payer: BCBS Complete |
$73.13
|
| Rate for Payer: BCBS MAPPO |
$109.42
|
| Rate for Payer: BCN Commercial |
$184.75
|
| Rate for Payer: BCN Medicare Advantage |
$109.42
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cash Price |
$344.80
|
| Rate for Payer: Cofinity Commercial |
$157.56
|
| Rate for Payer: Cofinity Commercial |
$146.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.42
|
| Rate for Payer: Healthscope Commercial |
$131.30
|
| Rate for Payer: Healthscope Whirlpool |
$131.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.89
|
| Rate for Payer: Meridian Medicaid |
$73.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.36
|
| Rate for Payer: Nomi Health Commercial |
$131.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$323.25
|
| Rate for Payer: PACE SWMI |
$109.42
|
| Rate for Payer: PHP Medicare Advantage |
$109.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$214.59
|
| Rate for Payer: Priority Health Medicare |
$109.42
|
| Rate for Payer: Priority Health Narrow Network |
$214.59
|
| Rate for Payer: Railroad Medicare Medicare |
$109.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$216.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$109.42
|
| Rate for Payer: UHC Exchange |
$216.91
|
| Rate for Payer: UHC Medicaid |
$69.65
|
| Rate for Payer: UHCCP DNSP |
$109.42
|
| Rate for Payer: UHCCP Medicaid |
$69.65
|
|
|
PR CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL
|
Professional
|
Both
|
$335.00
|
|
|
Service Code
|
HCPCS 64612
|
| Min. Negotiated Rate |
$69.01 |
| Max. Negotiated Rate |
$251.25 |
| Rate for Payer: Aetna Commercial |
$140.54
|
| Rate for Payer: Aetna Medicare |
$104.88
|
| Rate for Payer: BCBS Complete |
$72.46
|
| Rate for Payer: BCBS MAPPO |
$104.88
|
| Rate for Payer: BCN Commercial |
$141.37
|
| Rate for Payer: BCN Medicare Advantage |
$104.88
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cofinity Commercial |
$151.03
|
| Rate for Payer: Cofinity Commercial |
$140.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.88
|
| Rate for Payer: Healthscope Commercial |
$125.86
|
| Rate for Payer: Healthscope Whirlpool |
$125.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.12
|
| Rate for Payer: Meridian Medicaid |
$72.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.37
|
| Rate for Payer: Nomi Health Commercial |
$125.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.25
|
| Rate for Payer: PACE SWMI |
$104.88
|
| Rate for Payer: PHP Medicare Advantage |
$104.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$208.23
|
| Rate for Payer: Priority Health Medicare |
$104.88
|
| Rate for Payer: Priority Health Narrow Network |
$208.23
|
| Rate for Payer: Railroad Medicare Medicare |
$104.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$201.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.88
|
| Rate for Payer: UHC Exchange |
$201.44
|
| Rate for Payer: UHC Medicaid |
$69.01
|
| Rate for Payer: UHCCP DNSP |
$104.88
|
| Rate for Payer: UHCCP Medicaid |
$69.01
|
|
|
PR CHEMOTHERAPY ADMN IV INFUSION TQ EA HR
|
Professional
|
Both
|
$137.00
|
|
|
Service Code
|
HCPCS 96415
|
| Min. Negotiated Rate |
$26.62 |
| Max. Negotiated Rate |
$102.75 |
| Rate for Payer: Aetna Commercial |
$35.67
|
| Rate for Payer: Aetna Medicare |
$26.62
|
| Rate for Payer: BCBS MAPPO |
$26.62
|
| Rate for Payer: BCN Commercial |
$39.34
|
| Rate for Payer: BCN Medicare Advantage |
$26.62
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cofinity Commercial |
$35.67
|
| Rate for Payer: Cofinity Commercial |
$38.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.62
|
| Rate for Payer: Healthscope Commercial |
$31.94
|
| Rate for Payer: Healthscope Whirlpool |
$31.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.28
|
| Rate for Payer: Nomi Health Commercial |
$31.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.75
|
| Rate for Payer: PACE SWMI |
$26.62
|
| Rate for Payer: PHP Medicare Advantage |
$26.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$36.27
|
| Rate for Payer: Priority Health Medicare |
$26.62
|
| Rate for Payer: Priority Health Narrow Network |
$36.27
|
| Rate for Payer: Railroad Medicare Medicare |
$26.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.62
|
| Rate for Payer: UHC Exchange |
$28.71
|
| Rate for Payer: UHCCP DNSP |
$26.62
|
|
|
PR CHEMOTX ADMN CNS REQ SPINAL PUNCTURE
|
Professional
|
Both
|
$755.00
|
|
|
Service Code
|
HCPCS 96450
|
| Min. Negotiated Rate |
$42.39 |
| Max. Negotiated Rate |
$566.25 |
| Rate for Payer: Aetna Commercial |
$88.63
|
| Rate for Payer: Aetna Medicare |
$66.14
|
| Rate for Payer: BCBS Complete |
$44.51
|
| Rate for Payer: BCBS MAPPO |
$66.14
|
| Rate for Payer: BCN Commercial |
$114.04
|
| Rate for Payer: BCN Medicare Advantage |
$66.14
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cash Price |
$604.00
|
| Rate for Payer: Cofinity Commercial |
$95.24
|
| Rate for Payer: Cofinity Commercial |
$88.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.14
|
| Rate for Payer: Healthscope Commercial |
$79.37
|
| Rate for Payer: Healthscope Whirlpool |
$79.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.45
|
| Rate for Payer: Meridian Medicaid |
$44.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.75
|
| Rate for Payer: Nomi Health Commercial |
$79.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$566.25
|
| Rate for Payer: PACE SWMI |
$66.14
|
| Rate for Payer: PHP Medicare Advantage |
$66.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$105.16
|
| Rate for Payer: Priority Health Medicare |
$66.14
|
| Rate for Payer: Priority Health Narrow Network |
$105.16
|
| Rate for Payer: Railroad Medicare Medicare |
$66.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$79.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$66.14
|
| Rate for Payer: UHC Exchange |
$79.69
|
| Rate for Payer: UHC Medicaid |
$42.39
|
| Rate for Payer: UHCCP DNSP |
$66.14
|
| Rate for Payer: UHCCP Medicaid |
$42.39
|
|
|
PR CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 96417
|
| Min. Negotiated Rate |
$61.51 |
| Max. Negotiated Rate |
$102.00 |
| Rate for Payer: Aetna Commercial |
$82.42
|
| Rate for Payer: Aetna Medicare |
$61.51
|
| Rate for Payer: BCBS MAPPO |
$61.51
|
| Rate for Payer: BCN Commercial |
$90.63
|
| Rate for Payer: BCN Medicare Advantage |
$61.51
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Commercial |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$88.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.51
|
| Rate for Payer: Healthscope Commercial |
$73.81
|
| Rate for Payer: Healthscope Whirlpool |
$73.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$67.66
|
| Rate for Payer: Nomi Health Commercial |
$73.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.00
|
| Rate for Payer: PACE SWMI |
$61.51
|
| Rate for Payer: PHP Medicare Advantage |
$61.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$83.58
|
| Rate for Payer: Priority Health Medicare |
$61.51
|
| Rate for Payer: Priority Health Narrow Network |
$83.58
|
| Rate for Payer: Railroad Medicare Medicare |
$61.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$64.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$61.51
|
| Rate for Payer: UHC Exchange |
$64.20
|
| Rate for Payer: UHCCP DNSP |
$61.51
|
|
|
PR CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 96413
|
| Min. Negotiated Rate |
$122.99 |
| Max. Negotiated Rate |
$191.25 |
| Rate for Payer: Aetna Commercial |
$164.81
|
| Rate for Payer: Aetna Medicare |
$122.99
|
| Rate for Payer: BCBS MAPPO |
$122.99
|
| Rate for Payer: BCN Commercial |
$183.76
|
| Rate for Payer: BCN Medicare Advantage |
$122.99
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$164.81
|
| Rate for Payer: Cofinity Commercial |
$177.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.99
|
| Rate for Payer: Healthscope Commercial |
$147.59
|
| Rate for Payer: Healthscope Whirlpool |
$147.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$135.29
|
| Rate for Payer: Nomi Health Commercial |
$147.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.25
|
| Rate for Payer: PACE SWMI |
$122.99
|
| Rate for Payer: PHP Medicare Advantage |
$122.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$169.46
|
| Rate for Payer: Priority Health Medicare |
$122.99
|
| Rate for Payer: Priority Health Narrow Network |
$169.46
|
| Rate for Payer: Railroad Medicare Medicare |
$122.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$131.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.99
|
| Rate for Payer: UHC Exchange |
$131.57
|
| Rate for Payer: UHCCP DNSP |
$122.99
|
|
|
PR CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 96409
|
| Min. Negotiated Rate |
$96.58 |
| Max. Negotiated Rate |
$159.75 |
| Rate for Payer: Aetna Commercial |
$129.42
|
| Rate for Payer: Aetna Medicare |
$96.58
|
| Rate for Payer: BCBS MAPPO |
$96.58
|
| Rate for Payer: BCN Commercial |
$142.42
|
| Rate for Payer: BCN Medicare Advantage |
$96.58
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$129.42
|
| Rate for Payer: Cofinity Commercial |
$139.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.58
|
| Rate for Payer: Healthscope Commercial |
$115.90
|
| Rate for Payer: Healthscope Whirlpool |
$115.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$106.24
|
| Rate for Payer: Nomi Health Commercial |
$115.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.75
|
| Rate for Payer: PACE SWMI |
$96.58
|
| Rate for Payer: PHP Medicare Advantage |
$96.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$131.34
|
| Rate for Payer: Priority Health Medicare |
$96.58
|
| Rate for Payer: Priority Health Narrow Network |
$131.34
|
| Rate for Payer: Railroad Medicare Medicare |
$96.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$96.58
|
| Rate for Payer: UHC Exchange |
$101.70
|
| Rate for Payer: UHCCP DNSP |
$96.58
|
|
|
PR CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 96411
|
| Min. Negotiated Rate |
$52.94 |
| Max. Negotiated Rate |
$90.75 |
| Rate for Payer: Aetna Commercial |
$70.94
|
| Rate for Payer: Aetna Medicare |
$52.94
|
| Rate for Payer: BCBS MAPPO |
$52.94
|
| Rate for Payer: BCN Commercial |
$78.18
|
| Rate for Payer: BCN Medicare Advantage |
$52.94
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cofinity Commercial |
$70.94
|
| Rate for Payer: Cofinity Commercial |
$76.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.94
|
| Rate for Payer: Healthscope Commercial |
$63.53
|
| Rate for Payer: Healthscope Whirlpool |
$63.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$58.23
|
| Rate for Payer: Nomi Health Commercial |
$63.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.75
|
| Rate for Payer: PACE SWMI |
$52.94
|
| Rate for Payer: PHP Medicare Advantage |
$52.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$72.10
|
| Rate for Payer: Priority Health Medicare |
$52.94
|
| Rate for Payer: Priority Health Narrow Network |
$72.10
|
| Rate for Payer: Railroad Medicare Medicare |
$52.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.94
|
| Rate for Payer: UHC Exchange |
$55.58
|
| Rate for Payer: UHCCP DNSP |
$52.94
|
|
|
PR CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS 96402
|
| Min. Negotiated Rate |
$30.03 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Aetna Commercial |
$48.33
|
| Rate for Payer: Aetna Medicare |
$36.07
|
| Rate for Payer: BCBS MAPPO |
$36.07
|
| Rate for Payer: BCN Commercial |
$53.78
|
| Rate for Payer: BCN Medicare Advantage |
$36.07
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cofinity Commercial |
$48.33
|
| Rate for Payer: Cofinity Commercial |
$51.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.07
|
| Rate for Payer: Healthscope Commercial |
$43.28
|
| Rate for Payer: Healthscope Whirlpool |
$43.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.68
|
| Rate for Payer: Nomi Health Commercial |
$43.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.75
|
| Rate for Payer: PACE SWMI |
$36.07
|
| Rate for Payer: PHP Medicare Advantage |
$36.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$49.59
|
| Rate for Payer: Priority Health Medicare |
$36.07
|
| Rate for Payer: Priority Health Narrow Network |
$49.59
|
| Rate for Payer: Railroad Medicare Medicare |
$36.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.07
|
| Rate for Payer: UHC Exchange |
$30.03
|
| Rate for Payer: UHCCP DNSP |
$36.07
|
|
|
PR CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 96401
|
| Min. Negotiated Rate |
$66.46 |
| Max. Negotiated Rate |
$102.08 |
| Rate for Payer: Aetna Commercial |
$89.06
|
| Rate for Payer: Aetna Medicare |
$66.46
|
| Rate for Payer: BCBS MAPPO |
$66.46
|
| Rate for Payer: BCN Commercial |
$102.08
|
| Rate for Payer: BCN Medicare Advantage |
$66.46
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$89.06
|
| Rate for Payer: Cofinity Commercial |
$95.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.46
|
| Rate for Payer: Healthscope Commercial |
$79.75
|
| Rate for Payer: Healthscope Whirlpool |
$79.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.11
|
| Rate for Payer: Nomi Health Commercial |
$79.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.25
|
| Rate for Payer: PACE SWMI |
$66.46
|
| Rate for Payer: PHP Medicare Advantage |
$66.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$94.14
|
| Rate for Payer: Priority Health Medicare |
$66.46
|
| Rate for Payer: Priority Health Narrow Network |
$94.14
|
| Rate for Payer: Railroad Medicare Medicare |
$66.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$66.46
|
| Rate for Payer: UHC Exchange |
$74.10
|
| Rate for Payer: UHCCP DNSP |
$66.46
|
|
|
PR CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT
|
Professional
|
Both
|
$293.00
|
|
|
Service Code
|
HCPCS 96542
|
| Min. Negotiated Rate |
$22.79 |
| Max. Negotiated Rate |
$219.75 |
| Rate for Payer: Aetna Commercial |
$47.22
|
| Rate for Payer: Aetna Medicare |
$35.24
|
| Rate for Payer: BCBS Complete |
$23.93
|
| Rate for Payer: BCBS MAPPO |
$35.24
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: BCN Medicare Advantage |
$35.24
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cofinity Commercial |
$50.75
|
| Rate for Payer: Cofinity Commercial |
$47.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.24
|
| Rate for Payer: Healthscope Commercial |
$42.29
|
| Rate for Payer: Healthscope Whirlpool |
$42.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.00
|
| Rate for Payer: Meridian Medicaid |
$23.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.76
|
| Rate for Payer: Nomi Health Commercial |
$42.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.75
|
| Rate for Payer: PACE SWMI |
$35.24
|
| Rate for Payer: PHP Medicare Advantage |
$35.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$56.49
|
| Rate for Payer: Priority Health Medicare |
$35.24
|
| Rate for Payer: Priority Health Narrow Network |
$56.49
|
| Rate for Payer: Railroad Medicare Medicare |
$35.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.24
|
| Rate for Payer: UHC Exchange |
$42.50
|
| Rate for Payer: UHC Medicaid |
$22.79
|
| Rate for Payer: UHCCP DNSP |
$35.24
|
| Rate for Payer: UHCCP Medicaid |
$22.79
|
|
|
PR CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 98941
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$48.00 |
| Rate for Payer: Aetna Commercial |
$37.10
|
| Rate for Payer: Aetna Medicare |
$27.69
|
| Rate for Payer: BCBS Complete |
$25.60
|
| Rate for Payer: BCBS MAPPO |
$27.69
|
| Rate for Payer: BCN Commercial |
$33.72
|
| Rate for Payer: BCN Medicare Advantage |
$27.69
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$39.87
|
| Rate for Payer: Cofinity Commercial |
$37.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.69
|
| Rate for Payer: Healthscope Commercial |
$33.23
|
| Rate for Payer: Healthscope Whirlpool |
$33.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.46
|
| Rate for Payer: Nomi Health Commercial |
$33.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.00
|
| Rate for Payer: PACE SWMI |
$27.69
|
| Rate for Payer: PHP Medicare Advantage |
$27.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.38
|
| Rate for Payer: Priority Health Medicare |
$27.69
|
| Rate for Payer: Priority Health Narrow Network |
$46.38
|
| Rate for Payer: Railroad Medicare Medicare |
$27.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.69
|
| Rate for Payer: UHC Exchange |
$31.11
|
| Rate for Payer: UHCCP DNSP |
$27.69
|
|
|
PR CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 50688
|
| Min. Negotiated Rate |
$45.37 |
| Max. Negotiated Rate |
$135.69 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna Medicare |
$69.29
|
| Rate for Payer: BCBS Complete |
$47.64
|
| Rate for Payer: BCBS MAPPO |
$69.29
|
| Rate for Payer: BCN Commercial |
$117.02
|
| Rate for Payer: BCN Medicare Advantage |
$69.29
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cofinity Commercial |
$99.78
|
| Rate for Payer: Cofinity Commercial |
$92.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.29
|
| Rate for Payer: Healthscope Commercial |
$83.15
|
| Rate for Payer: Healthscope Whirlpool |
$83.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.75
|
| Rate for Payer: Meridian Medicaid |
$47.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.22
|
| Rate for Payer: Nomi Health Commercial |
$83.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.25
|
| Rate for Payer: PACE SWMI |
$69.29
|
| Rate for Payer: PHP Medicare Advantage |
$69.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$127.47
|
| Rate for Payer: Priority Health Medicare |
$69.29
|
| Rate for Payer: Priority Health Narrow Network |
$127.47
|
| Rate for Payer: Railroad Medicare Medicare |
$69.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$69.29
|
| Rate for Payer: UHC Exchange |
$135.69
|
| Rate for Payer: UHC Medicaid |
$45.37
|
| Rate for Payer: UHCCP DNSP |
$69.29
|
| Rate for Payer: UHCCP Medicaid |
$45.37
|
|
|
PR CHOLECSTC EXPL DUX SPHNCTROTOMY/SPHNCTROP
|
Professional
|
Both
|
$2,184.00
|
|
|
Service Code
|
HCPCS 47620
|
| Min. Negotiated Rate |
$818.13 |
| Max. Negotiated Rate |
$2,512.59 |
| Rate for Payer: Aetna Commercial |
$1,715.33
|
| Rate for Payer: Aetna Medicare |
$1,280.10
|
| Rate for Payer: BCBS Complete |
$859.04
|
| Rate for Payer: BCBS MAPPO |
$1,280.10
|
| Rate for Payer: BCN Commercial |
$2,062.14
|
| Rate for Payer: BCN Medicare Advantage |
$1,280.10
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cash Price |
$1,747.20
|
| Rate for Payer: Cofinity Commercial |
$1,843.34
|
| Rate for Payer: Cofinity Commercial |
$1,715.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,280.10
|
| Rate for Payer: Healthscope Commercial |
$1,536.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,536.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,344.11
|
| Rate for Payer: Meridian Medicaid |
$859.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,408.11
|
| Rate for Payer: Nomi Health Commercial |
$1,536.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,638.00
|
| Rate for Payer: PACE SWMI |
$1,280.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,280.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$818.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,512.59
|
| Rate for Payer: Priority Health Medicare |
$1,280.10
|
| Rate for Payer: Priority Health Narrow Network |
$2,512.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,280.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,462.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,280.10
|
| Rate for Payer: UHC Exchange |
$2,462.40
|
| Rate for Payer: UHC Medicaid |
$818.13
|
| Rate for Payer: UHCCP DNSP |
$1,280.10
|
| Rate for Payer: UHCCP Medicaid |
$818.13
|
|
|
PR CHOLECSTONTRSTM ROUX-EN-Y W/GASTRONTRSTM
|
Professional
|
Both
|
$2,723.00
|
|
|
Service Code
|
HCPCS 47741
|
| Min. Negotiated Rate |
$883.10 |
| Max. Negotiated Rate |
$2,698.85 |
| Rate for Payer: Aetna Commercial |
$1,847.10
|
| Rate for Payer: Aetna Medicare |
$1,378.43
|
| Rate for Payer: BCBS Complete |
$927.25
|
| Rate for Payer: BCBS MAPPO |
$1,378.43
|
| Rate for Payer: BCN Commercial |
$2,215.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,378.43
|
| Rate for Payer: Cash Price |
$2,178.40
|
| Rate for Payer: Cash Price |
$2,178.40
|
| Rate for Payer: Cofinity Commercial |
$1,984.94
|
| Rate for Payer: Cofinity Commercial |
$1,847.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,378.43
|
| Rate for Payer: Healthscope Commercial |
$1,654.12
|
| Rate for Payer: Healthscope Whirlpool |
$1,654.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,447.35
|
| Rate for Payer: Meridian Medicaid |
$927.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,516.27
|
| Rate for Payer: Nomi Health Commercial |
$1,654.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,042.25
|
| Rate for Payer: PACE SWMI |
$1,378.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,378.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$883.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,698.85
|
| Rate for Payer: Priority Health Medicare |
$1,378.43
|
| Rate for Payer: Priority Health Narrow Network |
$2,698.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,378.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,636.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,378.43
|
| Rate for Payer: UHC Exchange |
$2,636.64
|
| Rate for Payer: UHC Medicaid |
$883.10
|
| Rate for Payer: UHCCP DNSP |
$1,378.43
|
| Rate for Payer: UHCCP Medicaid |
$883.10
|
|
|
PR CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX
|
Professional
|
Both
|
$2,702.00
|
|
|
Service Code
|
HCPCS 47480
|
| Min. Negotiated Rate |
$534.20 |
| Max. Negotiated Rate |
$2,026.50 |
| Rate for Payer: Aetna Commercial |
$1,105.90
|
| Rate for Payer: Aetna Medicare |
$825.30
|
| Rate for Payer: BCBS Complete |
$560.91
|
| Rate for Payer: BCBS MAPPO |
$825.30
|
| Rate for Payer: BCN Commercial |
$1,325.13
|
| Rate for Payer: BCN Medicare Advantage |
$825.30
|
| Rate for Payer: Cash Price |
$2,161.60
|
| Rate for Payer: Cash Price |
$2,161.60
|
| Rate for Payer: Cofinity Commercial |
$1,188.43
|
| Rate for Payer: Cofinity Commercial |
$1,105.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$825.30
|
| Rate for Payer: Healthscope Commercial |
$990.36
|
| Rate for Payer: Healthscope Whirlpool |
$990.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$866.57
|
| Rate for Payer: Meridian Medicaid |
$560.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$907.83
|
| Rate for Payer: Nomi Health Commercial |
$990.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,026.50
|
| Rate for Payer: PACE SWMI |
$825.30
|
| Rate for Payer: PHP Medicare Advantage |
$825.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,614.58
|
| Rate for Payer: Priority Health Medicare |
$825.30
|
| Rate for Payer: Priority Health Narrow Network |
$1,614.58
|
| Rate for Payer: Railroad Medicare Medicare |
$825.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,559.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$825.30
|
| Rate for Payer: UHC Exchange |
$1,559.16
|
| Rate for Payer: UHC Medicaid |
$534.20
|
| Rate for Payer: UHCCP DNSP |
$825.30
|
| Rate for Payer: UHCCP Medicaid |
$534.20
|
|
|
PR CHOLECYSTECTOMY
|
Professional
|
Both
|
$2,696.00
|
|
|
Service Code
|
HCPCS 47600
|
| Min. Negotiated Rate |
$644.33 |
| Max. Negotiated Rate |
$2,022.00 |
| Rate for Payer: Aetna Commercial |
$1,344.52
|
| Rate for Payer: Aetna Medicare |
$1,003.37
|
| Rate for Payer: BCBS Complete |
$676.55
|
| Rate for Payer: BCBS MAPPO |
$1,003.37
|
| Rate for Payer: BCN Commercial |
$1,613.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,003.37
|
| Rate for Payer: Cash Price |
$2,156.80
|
| Rate for Payer: Cash Price |
$2,156.80
|
| Rate for Payer: Cofinity Commercial |
$1,444.85
|
| Rate for Payer: Cofinity Commercial |
$1,344.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,003.37
|
| Rate for Payer: Healthscope Commercial |
$1,204.04
|
| Rate for Payer: Healthscope Whirlpool |
$1,204.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,053.54
|
| Rate for Payer: Meridian Medicaid |
$676.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,103.71
|
| Rate for Payer: Nomi Health Commercial |
$1,204.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,022.00
|
| Rate for Payer: PACE SWMI |
$1,003.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,003.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$644.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,965.90
|
| Rate for Payer: Priority Health Medicare |
$1,003.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,965.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,003.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,906.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,003.37
|
| Rate for Payer: UHC Exchange |
$1,906.07
|
| Rate for Payer: UHC Medicaid |
$644.33
|
| Rate for Payer: UHCCP DNSP |
$1,003.37
|
| Rate for Payer: UHCCP Medicaid |
$644.33
|
|
|
PR CHOLECYSTECTOMY EXPL DUCT CHOLEDOCHOENTEROSTOMY
|
Professional
|
Both
|
$4,851.00
|
|
|
Service Code
|
HCPCS 47612
|
| Min. Negotiated Rate |
$759.77 |
| Max. Negotiated Rate |
$3,638.25 |
| Rate for Payer: Aetna Commercial |
$1,591.59
|
| Rate for Payer: Aetna Medicare |
$1,187.75
|
| Rate for Payer: BCBS Complete |
$797.76
|
| Rate for Payer: BCBS MAPPO |
$1,187.75
|
| Rate for Payer: BCN Commercial |
$1,910.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,187.75
|
| Rate for Payer: Cash Price |
$3,880.80
|
| Rate for Payer: Cash Price |
$3,880.80
|
| Rate for Payer: Cofinity Commercial |
$1,710.36
|
| Rate for Payer: Cofinity Commercial |
$1,591.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,187.75
|
| Rate for Payer: Healthscope Commercial |
$1,425.30
|
| Rate for Payer: Healthscope Whirlpool |
$1,425.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,247.14
|
| Rate for Payer: Meridian Medicaid |
$797.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,306.53
|
| Rate for Payer: Nomi Health Commercial |
$1,425.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,638.25
|
| Rate for Payer: PACE SWMI |
$1,187.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,187.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$759.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,328.14
|
| Rate for Payer: Priority Health Medicare |
$1,187.75
|
| Rate for Payer: Priority Health Narrow Network |
$2,328.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,187.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,280.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,187.75
|
| Rate for Payer: UHC Exchange |
$2,280.13
|
| Rate for Payer: UHC Medicaid |
$759.77
|
| Rate for Payer: UHCCP DNSP |
$1,187.75
|
| Rate for Payer: UHCCP Medicaid |
$759.77
|
|
|
PR CHOLECYSTECTOMY W/CHOLANGIOGRAPHY
|
Professional
|
Both
|
$3,099.00
|
|
|
Service Code
|
HCPCS 47605
|
| Min. Negotiated Rate |
$676.91 |
| Max. Negotiated Rate |
$2,324.25 |
| Rate for Payer: Aetna Commercial |
$1,413.86
|
| Rate for Payer: Aetna Medicare |
$1,055.12
|
| Rate for Payer: BCBS Complete |
$710.76
|
| Rate for Payer: BCBS MAPPO |
$1,055.12
|
| Rate for Payer: BCN Commercial |
$1,696.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,055.12
|
| Rate for Payer: Cash Price |
$2,479.20
|
| Rate for Payer: Cash Price |
$2,479.20
|
| Rate for Payer: Cofinity Commercial |
$1,519.37
|
| Rate for Payer: Cofinity Commercial |
$1,413.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,055.12
|
| Rate for Payer: Healthscope Commercial |
$1,266.14
|
| Rate for Payer: Healthscope Whirlpool |
$1,266.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,107.88
|
| Rate for Payer: Meridian Medicaid |
$710.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,160.63
|
| Rate for Payer: Nomi Health Commercial |
$1,266.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,324.25
|
| Rate for Payer: PACE SWMI |
$1,055.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,055.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$676.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,067.23
|
| Rate for Payer: Priority Health Medicare |
$1,055.12
|
| Rate for Payer: Priority Health Narrow Network |
$2,067.23
|
| Rate for Payer: Railroad Medicare Medicare |
$1,055.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,006.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,055.12
|
| Rate for Payer: UHC Exchange |
$2,006.43
|
| Rate for Payer: UHC Medicaid |
$676.91
|
| Rate for Payer: UHCCP DNSP |
$1,055.12
|
| Rate for Payer: UHCCP Medicaid |
$676.91
|
|
|
PR CHOLECYSTECTOMY W/EXPLORATION COMMON DUCT
|
Professional
|
Both
|
$3,409.00
|
|
|
Service Code
|
HCPCS 47610
|
| Min. Negotiated Rate |
$748.48 |
| Max. Negotiated Rate |
$2,556.75 |
| Rate for Payer: Aetna Commercial |
$1,566.61
|
| Rate for Payer: Aetna Medicare |
$1,169.11
|
| Rate for Payer: BCBS Complete |
$785.90
|
| Rate for Payer: BCBS MAPPO |
$1,169.11
|
| Rate for Payer: BCN Commercial |
$1,885.35
|
| Rate for Payer: BCN Medicare Advantage |
$1,169.11
|
| Rate for Payer: Cash Price |
$2,727.20
|
| Rate for Payer: Cash Price |
$2,727.20
|
| Rate for Payer: Cofinity Commercial |
$1,683.52
|
| Rate for Payer: Cofinity Commercial |
$1,566.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,169.11
|
| Rate for Payer: Healthscope Commercial |
$1,402.93
|
| Rate for Payer: Healthscope Whirlpool |
$1,402.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,227.57
|
| Rate for Payer: Meridian Medicaid |
$785.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,286.02
|
| Rate for Payer: Nomi Health Commercial |
$1,402.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,556.75
|
| Rate for Payer: PACE SWMI |
$1,169.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,169.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$748.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,297.19
|
| Rate for Payer: Priority Health Medicare |
$1,169.11
|
| Rate for Payer: Priority Health Narrow Network |
$2,297.19
|
| Rate for Payer: Railroad Medicare Medicare |
$1,169.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,242.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,169.11
|
| Rate for Payer: UHC Exchange |
$2,242.16
|
| Rate for Payer: UHC Medicaid |
$748.48
|
| Rate for Payer: UHCCP DNSP |
$1,169.11
|
| Rate for Payer: UHCCP Medicaid |
$748.48
|
|
