|
PR INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL
|
Professional
|
Both
|
$1,484.00
|
|
|
Service Code
|
HCPCS 33206
|
| Min. Negotiated Rate |
$285.63 |
| Max. Negotiated Rate |
$1,398.41 |
| Rate for Payer: Aetna Commercial |
$597.84
|
| Rate for Payer: Aetna Medicare |
$446.15
|
| Rate for Payer: BCBS Complete |
$299.91
|
| Rate for Payer: BCBS MAPPO |
$446.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,398.41
|
| Rate for Payer: BCN Commercial |
$658.25
|
| Rate for Payer: BCN Medicare Advantage |
$446.15
|
| Rate for Payer: Cash Price |
$1,187.20
|
| Rate for Payer: Cash Price |
$1,187.20
|
| Rate for Payer: Cofinity Commercial |
$597.84
|
| Rate for Payer: Cofinity Commercial |
$642.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$446.15
|
| Rate for Payer: Healthscope Commercial |
$535.38
|
| Rate for Payer: Healthscope Whirlpool |
$535.38
|
| Rate for Payer: Meridian Medicaid |
$299.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$468.46
|
| Rate for Payer: PACE SWMI |
$446.15
|
| Rate for Payer: PHP Medicare Advantage |
$446.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$285.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$716.55
|
| Rate for Payer: Priority Health Medicare |
$446.15
|
| Rate for Payer: Priority Health Narrow Network |
$716.55
|
| Rate for Payer: UHC Medicare Advantage |
$459.53
|
|
|
PR INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT
|
Professional
|
Both
|
$1,632.00
|
|
|
Service Code
|
HCPCS 33208
|
| Min. Negotiated Rate |
$324.83 |
| Max. Negotiated Rate |
$1,548.45 |
| Rate for Payer: Aetna Commercial |
$682.42
|
| Rate for Payer: Aetna Medicare |
$509.27
|
| Rate for Payer: BCBS Complete |
$341.07
|
| Rate for Payer: BCBS MAPPO |
$509.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,548.45
|
| Rate for Payer: BCN Commercial |
$748.66
|
| Rate for Payer: BCN Medicare Advantage |
$509.27
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Cash Price |
$1,305.60
|
| Rate for Payer: Cofinity Commercial |
$733.35
|
| Rate for Payer: Cofinity Commercial |
$682.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.27
|
| Rate for Payer: Healthscope Commercial |
$611.12
|
| Rate for Payer: Healthscope Whirlpool |
$611.12
|
| Rate for Payer: Meridian Medicaid |
$341.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$534.73
|
| Rate for Payer: PACE SWMI |
$509.27
|
| Rate for Payer: PHP Medicare Advantage |
$509.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,142.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$814.96
|
| Rate for Payer: Priority Health Medicare |
$509.27
|
| Rate for Payer: Priority Health Narrow Network |
$814.96
|
| Rate for Payer: UHC Medicare Advantage |
$524.55
|
|
|
PR INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR
|
Professional
|
Both
|
$1,780.00
|
|
|
Service Code
|
HCPCS 33207
|
| Min. Negotiated Rate |
$300.12 |
| Max. Negotiated Rate |
$1,343.47 |
| Rate for Payer: Aetna Commercial |
$629.42
|
| Rate for Payer: Aetna Medicare |
$469.72
|
| Rate for Payer: BCBS Complete |
$315.13
|
| Rate for Payer: BCBS MAPPO |
$469.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,343.47
|
| Rate for Payer: BCN Commercial |
$690.99
|
| Rate for Payer: BCN Medicare Advantage |
$469.72
|
| Rate for Payer: Cash Price |
$1,424.00
|
| Rate for Payer: Cash Price |
$1,424.00
|
| Rate for Payer: Cofinity Commercial |
$629.42
|
| Rate for Payer: Cofinity Commercial |
$676.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$469.72
|
| Rate for Payer: Healthscope Commercial |
$563.66
|
| Rate for Payer: Healthscope Whirlpool |
$563.66
|
| Rate for Payer: Meridian Medicaid |
$315.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$493.21
|
| Rate for Payer: PACE SWMI |
$469.72
|
| Rate for Payer: PHP Medicare Advantage |
$469.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$300.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,246.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$752.20
|
| Rate for Payer: Priority Health Medicare |
$469.72
|
| Rate for Payer: Priority Health Narrow Network |
$752.20
|
| Rate for Payer: UHC Medicare Advantage |
$483.81
|
|
|
PR INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS
|
Professional
|
Both
|
$1,246.00
|
|
|
Service Code
|
HCPCS 33213
|
| Min. Negotiated Rate |
$213.00 |
| Max. Negotiated Rate |
$1,352.98 |
| Rate for Payer: Aetna Commercial |
$441.78
|
| Rate for Payer: Aetna Medicare |
$329.69
|
| Rate for Payer: BCBS Complete |
$223.65
|
| Rate for Payer: BCBS MAPPO |
$329.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,352.98
|
| Rate for Payer: BCN Commercial |
$486.24
|
| Rate for Payer: BCN Medicare Advantage |
$329.69
|
| Rate for Payer: Cash Price |
$996.80
|
| Rate for Payer: Cash Price |
$996.80
|
| Rate for Payer: Cofinity Commercial |
$474.75
|
| Rate for Payer: Cofinity Commercial |
$441.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.69
|
| Rate for Payer: Healthscope Commercial |
$395.63
|
| Rate for Payer: Healthscope Whirlpool |
$395.63
|
| Rate for Payer: Meridian Medicaid |
$223.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$346.17
|
| Rate for Payer: PACE SWMI |
$329.69
|
| Rate for Payer: PHP Medicare Advantage |
$329.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$213.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$529.30
|
| Rate for Payer: Priority Health Medicare |
$329.69
|
| Rate for Payer: Priority Health Narrow Network |
$529.30
|
| Rate for Payer: UHC Medicare Advantage |
$339.58
|
|
|
PR INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS
|
Professional
|
Both
|
$729.00
|
|
|
Service Code
|
HCPCS 33221
|
| Min. Negotiated Rate |
$224.93 |
| Max. Negotiated Rate |
$1,089.35 |
| Rate for Payer: Aetna Commercial |
$471.64
|
| Rate for Payer: Aetna Medicare |
$351.97
|
| Rate for Payer: BCBS Complete |
$236.18
|
| Rate for Payer: BCBS MAPPO |
$351.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,089.35
|
| Rate for Payer: BCN Commercial |
$519.95
|
| Rate for Payer: BCN Medicare Advantage |
$351.97
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cash Price |
$583.20
|
| Rate for Payer: Cofinity Commercial |
$506.84
|
| Rate for Payer: Cofinity Commercial |
$471.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.97
|
| Rate for Payer: Healthscope Commercial |
$422.36
|
| Rate for Payer: Healthscope Whirlpool |
$422.36
|
| Rate for Payer: Meridian Medicaid |
$236.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$369.57
|
| Rate for Payer: PACE SWMI |
$351.97
|
| Rate for Payer: PHP Medicare Advantage |
$351.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$566.00
|
| Rate for Payer: Priority Health Medicare |
$351.97
|
| Rate for Payer: Priority Health Narrow Network |
$566.00
|
| Rate for Payer: UHC Medicare Advantage |
$362.53
|
|
|
PR INS PM PLS GEN W/EXIST SINGLE LEAD
|
Professional
|
Both
|
$1,098.00
|
|
|
Service Code
|
HCPCS 33212
|
| Min. Negotiated Rate |
$203.42 |
| Max. Negotiated Rate |
$1,488.75 |
| Rate for Payer: Aetna Commercial |
$422.11
|
| Rate for Payer: Aetna Medicare |
$315.01
|
| Rate for Payer: BCBS Complete |
$213.59
|
| Rate for Payer: BCBS MAPPO |
$315.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,488.75
|
| Rate for Payer: BCN Commercial |
$464.73
|
| Rate for Payer: BCN Medicare Advantage |
$315.01
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cash Price |
$878.40
|
| Rate for Payer: Cofinity Commercial |
$453.61
|
| Rate for Payer: Cofinity Commercial |
$422.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.01
|
| Rate for Payer: Healthscope Commercial |
$378.01
|
| Rate for Payer: Healthscope Whirlpool |
$378.01
|
| Rate for Payer: Meridian Medicaid |
$213.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$330.76
|
| Rate for Payer: PACE SWMI |
$315.01
|
| Rate for Payer: PHP Medicare Advantage |
$315.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$505.90
|
| Rate for Payer: Priority Health Medicare |
$315.01
|
| Rate for Payer: Priority Health Narrow Network |
$505.90
|
| Rate for Payer: UHC Medicare Advantage |
$324.46
|
|
|
PR INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD
|
Professional
|
Both
|
$1,153.00
|
|
|
Service Code
|
HCPCS 33270
|
| Min. Negotiated Rate |
$351.45 |
| Max. Negotiated Rate |
$1,575.39 |
| Rate for Payer: Aetna Commercial |
$739.36
|
| Rate for Payer: Aetna Medicare |
$551.76
|
| Rate for Payer: BCBS Complete |
$369.02
|
| Rate for Payer: BCBS MAPPO |
$551.76
|
| Rate for Payer: BCBS Trust/PPO |
$1,575.39
|
| Rate for Payer: BCN Commercial |
$812.18
|
| Rate for Payer: BCN Medicare Advantage |
$551.76
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cash Price |
$922.40
|
| Rate for Payer: Cofinity Commercial |
$794.53
|
| Rate for Payer: Cofinity Commercial |
$739.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$551.76
|
| Rate for Payer: Healthscope Commercial |
$662.11
|
| Rate for Payer: Healthscope Whirlpool |
$662.11
|
| Rate for Payer: Meridian Medicaid |
$369.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$579.35
|
| Rate for Payer: PACE SWMI |
$551.76
|
| Rate for Payer: PHP Medicare Advantage |
$551.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$351.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$884.12
|
| Rate for Payer: Priority Health Medicare |
$551.76
|
| Rate for Payer: Priority Health Narrow Network |
$884.12
|
| Rate for Payer: UHC Medicare Advantage |
$568.31
|
|
|
PR INSRT CH WALL RESPIR ELTRD/RA & CONJ PULSE GEN
|
Professional
|
Both
|
$475.00
|
|
|
Service Code
|
HCPCS 0466T
|
| Min. Negotiated Rate |
$190.00 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: BCBS Complete |
$190.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.50
|
|
|
PR INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 32562
|
| Min. Negotiated Rate |
$37.70 |
| Max. Negotiated Rate |
$724.30 |
| Rate for Payer: Aetna Commercial |
$79.27
|
| Rate for Payer: Aetna Medicare |
$59.16
|
| Rate for Payer: BCBS Complete |
$39.58
|
| Rate for Payer: BCBS MAPPO |
$59.16
|
| Rate for Payer: BCBS Trust/PPO |
$724.30
|
| Rate for Payer: BCN Commercial |
$122.17
|
| Rate for Payer: BCN Medicare Advantage |
$59.16
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cofinity Commercial |
$79.27
|
| Rate for Payer: Cofinity Commercial |
$85.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.16
|
| Rate for Payer: Healthscope Commercial |
$70.99
|
| Rate for Payer: Healthscope Whirlpool |
$70.99
|
| Rate for Payer: Meridian Medicaid |
$39.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$62.12
|
| Rate for Payer: PACE SWMI |
$59.16
|
| Rate for Payer: PHP Medicare Advantage |
$59.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.96
|
| Rate for Payer: Priority Health Medicare |
$59.16
|
| Rate for Payer: Priority Health Narrow Network |
$81.96
|
| Rate for Payer: UHC Medicare Advantage |
$60.93
|
|
|
PR INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS
|
Professional
|
Both
|
$446.00
|
|
|
Service Code
|
HCPCS 32560
|
| Min. Negotiated Rate |
$47.71 |
| Max. Negotiated Rate |
$722.19 |
| Rate for Payer: Aetna Commercial |
$100.19
|
| Rate for Payer: Aetna Medicare |
$74.77
|
| Rate for Payer: BCBS Complete |
$50.10
|
| Rate for Payer: BCBS MAPPO |
$74.77
|
| Rate for Payer: BCBS Trust/PPO |
$722.19
|
| Rate for Payer: BCN Commercial |
$373.84
|
| Rate for Payer: BCN Medicare Advantage |
$74.77
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cofinity Commercial |
$100.19
|
| Rate for Payer: Cofinity Commercial |
$107.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.77
|
| Rate for Payer: Healthscope Commercial |
$89.72
|
| Rate for Payer: Healthscope Whirlpool |
$89.72
|
| Rate for Payer: Meridian Medicaid |
$50.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.51
|
| Rate for Payer: PACE SWMI |
$74.77
|
| Rate for Payer: PHP Medicare Advantage |
$74.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.26
|
| Rate for Payer: Priority Health Medicare |
$74.77
|
| Rate for Payer: Priority Health Narrow Network |
$103.26
|
| Rate for Payer: UHC Medicare Advantage |
$77.01
|
|
|
PR INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 32561
|
| Min. Negotiated Rate |
$42.17 |
| Max. Negotiated Rate |
$892.83 |
| Rate for Payer: Aetna Commercial |
$89.22
|
| Rate for Payer: Aetna Medicare |
$66.58
|
| Rate for Payer: BCBS Complete |
$44.28
|
| Rate for Payer: BCBS MAPPO |
$66.58
|
| Rate for Payer: BCBS Trust/PPO |
$892.83
|
| Rate for Payer: BCN Commercial |
$136.83
|
| Rate for Payer: BCN Medicare Advantage |
$66.58
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$89.22
|
| Rate for Payer: Cofinity Commercial |
$95.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.58
|
| Rate for Payer: Healthscope Commercial |
$79.90
|
| Rate for Payer: Healthscope Whirlpool |
$79.90
|
| Rate for Payer: Meridian Medicaid |
$44.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.91
|
| Rate for Payer: PACE SWMI |
$66.58
|
| Rate for Payer: PHP Medicare Advantage |
$66.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.15
|
| Rate for Payer: Priority Health Medicare |
$66.58
|
| Rate for Payer: Priority Health Narrow Network |
$92.15
|
| Rate for Payer: UHC Medicare Advantage |
$68.58
|
|
|
PR INSTRUMENT BASED OCULAR SCR BI W/RMT ANAL & RPT
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 99174
|
| Min. Negotiated Rate |
$5.72 |
| Max. Negotiated Rate |
$544.15 |
| Rate for Payer: Aetna Commercial |
$5.72
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS Trust/PPO |
$544.15
|
| Rate for Payer: BCN Commercial |
$8.80
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.08
|
| Rate for Payer: Priority Health Narrow Network |
$8.08
|
|
|
PR INSULIN INJECTION
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS J1815
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Aetna Commercial |
$0.30
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.05
|
| Rate for Payer: BCN Commercial |
$0.05
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
|
|
PR INT ANAST PANCREATIC CYST GI TRACT DIRECT
|
Professional
|
Both
|
$1,927.00
|
|
|
Service Code
|
HCPCS 48520
|
| Min. Negotiated Rate |
$260.45 |
| Max. Negotiated Rate |
$1,935.02 |
| Rate for Payer: Aetna Commercial |
$1,468.84
|
| Rate for Payer: Aetna Medicare |
$1,096.15
|
| Rate for Payer: BCBS Complete |
$738.72
|
| Rate for Payer: BCBS MAPPO |
$1,096.15
|
| Rate for Payer: BCBS Trust/PPO |
$260.45
|
| Rate for Payer: BCN Commercial |
$1,608.24
|
| Rate for Payer: BCN Medicare Advantage |
$1,096.15
|
| Rate for Payer: Cash Price |
$1,541.60
|
| Rate for Payer: Cash Price |
$1,541.60
|
| Rate for Payer: Cofinity Commercial |
$1,468.84
|
| Rate for Payer: Cofinity Commercial |
$1,578.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,096.15
|
| Rate for Payer: Healthscope Commercial |
$1,315.38
|
| Rate for Payer: Healthscope Whirlpool |
$1,315.38
|
| Rate for Payer: Meridian Medicaid |
$738.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,150.96
|
| Rate for Payer: PACE SWMI |
$1,096.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,096.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$703.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,935.02
|
| Rate for Payer: Priority Health Medicare |
$1,096.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,935.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,129.03
|
|
|
PR INT ANAST PANCREATIC CYST GI TRACT ROUX-EN-Y
|
Professional
|
Both
|
$2,830.00
|
|
|
Service Code
|
HCPCS 48540
|
| Min. Negotiated Rate |
$502.41 |
| Max. Negotiated Rate |
$2,296.04 |
| Rate for Payer: Aetna Commercial |
$1,745.35
|
| Rate for Payer: Aetna Medicare |
$1,302.50
|
| Rate for Payer: BCBS Complete |
$876.71
|
| Rate for Payer: BCBS MAPPO |
$1,302.50
|
| Rate for Payer: BCBS Trust/PPO |
$502.41
|
| Rate for Payer: BCN Commercial |
$1,908.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,302.50
|
| Rate for Payer: Cash Price |
$2,264.00
|
| Rate for Payer: Cash Price |
$2,264.00
|
| Rate for Payer: Cofinity Commercial |
$1,875.60
|
| Rate for Payer: Cofinity Commercial |
$1,745.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,302.50
|
| Rate for Payer: Healthscope Commercial |
$1,563.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,563.00
|
| Rate for Payer: Meridian Medicaid |
$876.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,367.62
|
| Rate for Payer: PACE SWMI |
$1,302.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,302.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$834.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,981.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,296.04
|
| Rate for Payer: Priority Health Medicare |
$1,302.50
|
| Rate for Payer: Priority Health Narrow Network |
$2,296.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,341.58
|
|
|
PR INTENSIVE OUTPATIENT PSYCHIA
|
Professional
|
Both
|
$127.00
|
|
|
Service Code
|
HCPCS S9480
|
| Min. Negotiated Rate |
$50.80 |
| Max. Negotiated Rate |
$820.98 |
| Rate for Payer: Aetna Commercial |
$63.28
|
| Rate for Payer: BCBS Complete |
$50.80
|
| Rate for Payer: BCBS Trust/PPO |
$820.98
|
| Rate for Payer: BCN Commercial |
$256.38
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.90
|
|
|
PR INTER DEVC REMOTE 30D
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS G2066
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$1,033.35 |
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,033.35
|
| Rate for Payer: BCN Commercial |
$32.38
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.70
|
|
|
PR INTERMITTENT URINARY CATH
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS A4353
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$7.71 |
| Rate for Payer: Aetna Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCN Commercial |
$7.71
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.70
|
|
|
PR INTERNAL NEUROLYSIS REQ OPERATING MICROSCOPE
|
Professional
|
Both
|
$735.00
|
|
|
Service Code
|
HCPCS 64727
|
| Min. Negotiated Rate |
$113.32 |
| Max. Negotiated Rate |
$2,288.07 |
| Rate for Payer: Aetna Commercial |
$235.75
|
| Rate for Payer: Aetna Medicare |
$175.93
|
| Rate for Payer: BCBS Complete |
$118.99
|
| Rate for Payer: BCBS MAPPO |
$175.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,288.07
|
| Rate for Payer: BCN Commercial |
$259.98
|
| Rate for Payer: BCN Medicare Advantage |
$175.93
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cash Price |
$588.00
|
| Rate for Payer: Cofinity Commercial |
$253.34
|
| Rate for Payer: Cofinity Commercial |
$235.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.93
|
| Rate for Payer: Healthscope Commercial |
$211.12
|
| Rate for Payer: Healthscope Whirlpool |
$211.12
|
| Rate for Payer: Meridian Medicaid |
$118.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$184.73
|
| Rate for Payer: PACE SWMI |
$175.93
|
| Rate for Payer: PHP Medicare Advantage |
$175.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$514.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$301.23
|
| Rate for Payer: Priority Health Medicare |
$175.93
|
| Rate for Payer: Priority Health Narrow Network |
$301.23
|
| Rate for Payer: UHC Medicare Advantage |
$181.21
|
|
|
PR INTERNAL SPINAL FIXATION WIRING SPINOUS PROCESS
|
Professional
|
Both
|
$1,194.00
|
|
|
Service Code
|
HCPCS 22841
|
| Min. Negotiated Rate |
$123.16 |
| Max. Negotiated Rate |
$835.80 |
| Rate for Payer: Aetna Commercial |
$519.10
|
| Rate for Payer: BCBS Complete |
$477.60
|
| Rate for Payer: BCBS Trust/PPO |
$145.43
|
| Rate for Payer: BCN Commercial |
$123.16
|
| Rate for Payer: Cash Price |
$955.20
|
| Rate for Payer: Cash Price |
$955.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$835.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$596.44
|
| Rate for Payer: Priority Health Narrow Network |
$596.44
|
|
|
PR INTERPELVIABDOMINAL AMPUTATION
|
Professional
|
Both
|
$5,225.00
|
|
|
Service Code
|
HCPCS 27290
|
| Min. Negotiated Rate |
$1,039.87 |
| Max. Negotiated Rate |
$3,657.50 |
| Rate for Payer: Aetna Commercial |
$2,143.79
|
| Rate for Payer: Aetna Medicare |
$1,599.84
|
| Rate for Payer: BCBS Complete |
$1,091.86
|
| Rate for Payer: BCBS MAPPO |
$1,599.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,174.41
|
| Rate for Payer: BCN Commercial |
$2,371.55
|
| Rate for Payer: BCN Medicare Advantage |
$1,599.84
|
| Rate for Payer: Cash Price |
$4,180.00
|
| Rate for Payer: Cash Price |
$4,180.00
|
| Rate for Payer: Cofinity Commercial |
$2,143.79
|
| Rate for Payer: Cofinity Commercial |
$2,303.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,599.84
|
| Rate for Payer: Healthscope Commercial |
$1,919.81
|
| Rate for Payer: Healthscope Whirlpool |
$1,919.81
|
| Rate for Payer: Meridian Medicaid |
$1,091.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,679.83
|
| Rate for Payer: PACE SWMI |
$1,599.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,599.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,039.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,657.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,478.19
|
| Rate for Payer: Priority Health Medicare |
$1,599.84
|
| Rate for Payer: Priority Health Narrow Network |
$2,478.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,647.84
|
|
|
PR INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM FAMILY
|
Professional
|
Both
|
$149.00
|
|
|
Service Code
|
HCPCS 90887
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$104.30 |
| Rate for Payer: Aetna Commercial |
$83.11
|
| Rate for Payer: BCBS Complete |
$47.86
|
| Rate for Payer: BCBS Trust/PPO |
$60.75
|
| Rate for Payer: BCN Commercial |
$99.35
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Cash Price |
$119.20
|
| Rate for Payer: Meridian Medicaid |
$47.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.40
|
| Rate for Payer: Priority Health Narrow Network |
$98.40
|
|
|
PR INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 93261
|
| Min. Negotiated Rate |
$53.20 |
| Max. Negotiated Rate |
$756.00 |
| Rate for Payer: Aetna Commercial |
$90.09
|
| Rate for Payer: Aetna Medicare |
$67.23
|
| Rate for Payer: BCBS Complete |
$53.20
|
| Rate for Payer: BCBS MAPPO |
$67.23
|
| Rate for Payer: BCBS Trust/PPO |
$756.00
|
| Rate for Payer: BCN Commercial |
$102.62
|
| Rate for Payer: BCN Medicare Advantage |
$67.23
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cofinity Commercial |
$90.09
|
| Rate for Payer: Cofinity Commercial |
$96.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.23
|
| Rate for Payer: Healthscope Commercial |
$80.68
|
| Rate for Payer: Healthscope Whirlpool |
$80.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$70.59
|
| Rate for Payer: PACE SWMI |
$67.23
|
| Rate for Payer: PHP Medicare Advantage |
$67.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.30
|
| Rate for Payer: Priority Health Medicare |
$67.23
|
| Rate for Payer: Priority Health Narrow Network |
$99.30
|
| Rate for Payer: UHC Medicare Advantage |
$69.25
|
|
|
PR INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 93292
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$410.49 |
| Rate for Payer: Aetna Commercial |
$65.26
|
| Rate for Payer: Aetna Medicare |
$48.70
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCBS MAPPO |
$48.70
|
| Rate for Payer: BCBS Trust/PPO |
$410.49
|
| Rate for Payer: BCN Commercial |
$74.77
|
| Rate for Payer: BCN Medicare Advantage |
$48.70
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$70.13
|
| Rate for Payer: Cofinity Commercial |
$65.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.70
|
| Rate for Payer: Healthscope Commercial |
$58.44
|
| Rate for Payer: Healthscope Whirlpool |
$58.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$51.14
|
| Rate for Payer: PACE SWMI |
$48.70
|
| Rate for Payer: PHP Medicare Advantage |
$48.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.35
|
| Rate for Payer: Priority Health Medicare |
$48.70
|
| Rate for Payer: Priority Health Narrow Network |
$72.35
|
| Rate for Payer: UHC Medicare Advantage |
$50.16
|
|
|
PR INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB
|
Professional
|
Both
|
$197.00
|
|
|
Service Code
|
HCPCS 93295
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$274.19 |
| Rate for Payer: Aetna Commercial |
$47.97
|
| Rate for Payer: Aetna Medicare |
$35.80
|
| Rate for Payer: BCBS Complete |
$24.15
|
| Rate for Payer: BCBS MAPPO |
$35.80
|
| Rate for Payer: BCBS Trust/PPO |
$274.19
|
| Rate for Payer: BCN Commercial |
$52.78
|
| Rate for Payer: BCN Medicare Advantage |
$35.80
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$51.55
|
| Rate for Payer: Cofinity Commercial |
$47.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.80
|
| Rate for Payer: Healthscope Commercial |
$42.96
|
| Rate for Payer: Healthscope Whirlpool |
$42.96
|
| Rate for Payer: Meridian Medicaid |
$24.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.59
|
| Rate for Payer: PACE SWMI |
$35.80
|
| Rate for Payer: PHP Medicare Advantage |
$35.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.07
|
| Rate for Payer: Priority Health Medicare |
$35.80
|
| Rate for Payer: Priority Health Narrow Network |
$51.07
|
| Rate for Payer: UHC Medicare Advantage |
$36.87
|
|
