|
PR INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE
|
Professional
|
Both
|
$693.00
|
|
|
Service Code
|
HCPCS 41008
|
| Min. Negotiated Rate |
$165.50 |
| Max. Negotiated Rate |
$1,030.71 |
| Rate for Payer: Aetna Commercial |
$334.26
|
| Rate for Payer: Aetna Medicare |
$249.45
|
| Rate for Payer: BCBS Complete |
$173.78
|
| Rate for Payer: BCBS MAPPO |
$249.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,030.71
|
| Rate for Payer: BCN Commercial |
$575.17
|
| Rate for Payer: BCN Medicare Advantage |
$249.45
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cofinity Commercial |
$359.21
|
| Rate for Payer: Cofinity Commercial |
$334.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$249.45
|
| Rate for Payer: Healthscope Commercial |
$299.34
|
| Rate for Payer: Healthscope Whirlpool |
$299.34
|
| Rate for Payer: Meridian Medicaid |
$173.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$261.92
|
| Rate for Payer: PACE SWMI |
$249.45
|
| Rate for Payer: PHP Medicare Advantage |
$249.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$165.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$450.97
|
| Rate for Payer: Priority Health Medicare |
$249.45
|
| Rate for Payer: Priority Health Narrow Network |
$450.97
|
| Rate for Payer: UHC Medicare Advantage |
$256.93
|
|
|
PR INTRAPULMONARY SURFACTANT ADMINISTJ PHYS/QHP
|
Professional
|
Both
|
$110.00
|
|
|
Service Code
|
HCPCS 94610
|
| Min. Negotiated Rate |
$35.57 |
| Max. Negotiated Rate |
$1,160.68 |
| Rate for Payer: Aetna Commercial |
$73.95
|
| Rate for Payer: Aetna Medicare |
$55.19
|
| Rate for Payer: BCBS Complete |
$37.35
|
| Rate for Payer: BCBS MAPPO |
$55.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,160.68
|
| Rate for Payer: BCN Commercial |
$81.12
|
| Rate for Payer: BCN Medicare Advantage |
$55.19
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$79.47
|
| Rate for Payer: Cofinity Commercial |
$73.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.19
|
| Rate for Payer: Healthscope Commercial |
$66.23
|
| Rate for Payer: Healthscope Whirlpool |
$66.23
|
| Rate for Payer: Meridian Medicaid |
$37.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.95
|
| Rate for Payer: PACE SWMI |
$55.19
|
| Rate for Payer: PHP Medicare Advantage |
$55.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.55
|
| Rate for Payer: Priority Health Medicare |
$55.19
|
| Rate for Payer: Priority Health Narrow Network |
$74.55
|
| Rate for Payer: UHC Medicare Advantage |
$56.85
|
|
|
PR INTRAUT COPPER CONTRACEPTIVE
|
Professional
|
Both
|
$1,326.00
|
|
|
Service Code
|
HCPCS J7300
|
| Min. Negotiated Rate |
$896.88 |
| Max. Negotiated Rate |
$1,139.25 |
| Rate for Payer: Aetna Commercial |
$1,085.00
|
| Rate for Payer: BCBS Complete |
$1,139.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.19
|
| Rate for Payer: BCN Commercial |
$896.88
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Meridian Medicaid |
$1,139.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,085.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$928.20
|
|
|
PR INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL
|
Professional
|
Both
|
$416.00
|
|
|
Service Code
|
HCPCS 37253
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$1,099.39 |
| Rate for Payer: Aetna Commercial |
$92.98
|
| Rate for Payer: Aetna Medicare |
$69.39
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS MAPPO |
$69.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.39
|
| Rate for Payer: BCN Commercial |
$250.20
|
| Rate for Payer: BCN Medicare Advantage |
$69.39
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Cofinity Commercial |
$99.92
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.39
|
| Rate for Payer: Healthscope Commercial |
$83.27
|
| Rate for Payer: Healthscope Whirlpool |
$83.27
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.86
|
| Rate for Payer: PACE SWMI |
$69.39
|
| Rate for Payer: PHP Medicare Advantage |
$69.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$291.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.59
|
| Rate for Payer: Priority Health Medicare |
$69.39
|
| Rate for Payer: Priority Health Narrow Network |
$109.59
|
| Rate for Payer: UHC Medicare Advantage |
$71.47
|
|
|
PR INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL
|
Professional
|
Both
|
$189.00
|
|
|
Service Code
|
HCPCS 37252
|
| Min. Negotiated Rate |
$55.17 |
| Max. Negotiated Rate |
$1,597.58 |
| Rate for Payer: Aetna Commercial |
$117.45
|
| Rate for Payer: Aetna Medicare |
$87.65
|
| Rate for Payer: BCBS Complete |
$57.93
|
| Rate for Payer: BCBS MAPPO |
$87.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,597.58
|
| Rate for Payer: BCN Commercial |
$1,403.97
|
| Rate for Payer: BCN Medicare Advantage |
$87.65
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cash Price |
$151.20
|
| Rate for Payer: Cofinity Commercial |
$117.45
|
| Rate for Payer: Cofinity Commercial |
$126.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.65
|
| Rate for Payer: Healthscope Commercial |
$105.18
|
| Rate for Payer: Healthscope Whirlpool |
$105.18
|
| Rate for Payer: Meridian Medicaid |
$57.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$92.03
|
| Rate for Payer: PACE SWMI |
$87.65
|
| Rate for Payer: PHP Medicare Advantage |
$87.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.31
|
| Rate for Payer: Priority Health Medicare |
$87.65
|
| Rate for Payer: Priority Health Narrow Network |
$138.31
|
| Rate for Payer: UHC Medicare Advantage |
$90.28
|
|
|
PR INTRAVASC US DURING DX EVAL/ INTERVENTION,EA ADDN VESSEL
|
Professional
|
Both
|
$400.00
|
|
|
Service Code
|
HCPCS 37251
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$280.00 |
| Rate for Payer: BCBS Complete |
$160.00
|
| Rate for Payer: Cash Price |
$320.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.00
|
|
|
PR INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA
|
Professional
|
Both
|
$573.00
|
|
|
Service Code
|
HCPCS 93609
|
| Min. Negotiated Rate |
$229.20 |
| Max. Negotiated Rate |
$995.32 |
| Rate for Payer: Aetna Commercial |
$507.22
|
| Rate for Payer: BCBS Complete |
$229.20
|
| Rate for Payer: BCBS Trust/PPO |
$995.32
|
| Rate for Payer: BCN Commercial |
$544.39
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Cash Price |
$458.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$527.24
|
| Rate for Payer: Priority Health Narrow Network |
$527.24
|
|
|
PR INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX
|
Professional
|
Both
|
$217.00
|
|
|
Service Code
|
HCPCS 57180
|
| Min. Negotiated Rate |
$77.96 |
| Max. Negotiated Rate |
$527.77 |
| Rate for Payer: Aetna Commercial |
$159.94
|
| Rate for Payer: Aetna Medicare |
$119.36
|
| Rate for Payer: BCBS Complete |
$81.86
|
| Rate for Payer: BCBS MAPPO |
$119.36
|
| Rate for Payer: BCBS Trust/PPO |
$527.77
|
| Rate for Payer: BCN Commercial |
$295.16
|
| Rate for Payer: BCN Medicare Advantage |
$119.36
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cofinity Commercial |
$171.88
|
| Rate for Payer: Cofinity Commercial |
$159.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.36
|
| Rate for Payer: Healthscope Commercial |
$143.23
|
| Rate for Payer: Healthscope Whirlpool |
$143.23
|
| Rate for Payer: Meridian Medicaid |
$81.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$125.33
|
| Rate for Payer: PACE SWMI |
$119.36
|
| Rate for Payer: PHP Medicare Advantage |
$119.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$173.28
|
| Rate for Payer: Priority Health Medicare |
$119.36
|
| Rate for Payer: Priority Health Narrow Network |
$173.28
|
| Rate for Payer: UHC Medicare Advantage |
$122.94
|
|
|
PR INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I
|
Professional
|
Both
|
$371.00
|
|
|
Service Code
|
HCPCS 36901
|
| Min. Negotiated Rate |
$104.37 |
| Max. Negotiated Rate |
$1,036.97 |
| Rate for Payer: Aetna Commercial |
$220.51
|
| Rate for Payer: Aetna Medicare |
$164.56
|
| Rate for Payer: BCBS Complete |
$109.59
|
| Rate for Payer: BCBS MAPPO |
$164.56
|
| Rate for Payer: BCBS Trust/PPO |
$647.17
|
| Rate for Payer: BCN Commercial |
$1,036.97
|
| Rate for Payer: BCN Medicare Advantage |
$164.56
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cofinity Commercial |
$236.97
|
| Rate for Payer: Cofinity Commercial |
$220.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.56
|
| Rate for Payer: Healthscope Commercial |
$197.47
|
| Rate for Payer: Healthscope Whirlpool |
$197.47
|
| Rate for Payer: Meridian Medicaid |
$109.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$172.79
|
| Rate for Payer: PACE SWMI |
$164.56
|
| Rate for Payer: PHP Medicare Advantage |
$164.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$261.20
|
| Rate for Payer: Priority Health Medicare |
$164.56
|
| Rate for Payer: Priority Health Narrow Network |
$261.20
|
| Rate for Payer: UHC Medicare Advantage |
$169.50
|
|
|
PR INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT
|
Professional
|
Both
|
$756.00
|
|
|
Service Code
|
HCPCS 36903
|
| Min. Negotiated Rate |
$195.75 |
| Max. Negotiated Rate |
$6,303.94 |
| Rate for Payer: Aetna Commercial |
$412.51
|
| Rate for Payer: Aetna Medicare |
$307.84
|
| Rate for Payer: BCBS Complete |
$205.54
|
| Rate for Payer: BCBS MAPPO |
$307.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,744.97
|
| Rate for Payer: BCN Commercial |
$6,303.94
|
| Rate for Payer: BCN Medicare Advantage |
$307.84
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cash Price |
$604.80
|
| Rate for Payer: Cofinity Commercial |
$443.29
|
| Rate for Payer: Cofinity Commercial |
$412.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$307.84
|
| Rate for Payer: Healthscope Commercial |
$369.41
|
| Rate for Payer: Healthscope Whirlpool |
$369.41
|
| Rate for Payer: Meridian Medicaid |
$205.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$323.23
|
| Rate for Payer: PACE SWMI |
$307.84
|
| Rate for Payer: PHP Medicare Advantage |
$307.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$195.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$487.81
|
| Rate for Payer: Priority Health Medicare |
$307.84
|
| Rate for Payer: Priority Health Narrow Network |
$487.81
|
| Rate for Payer: UHC Medicare Advantage |
$317.08
|
|
|
PR INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP
|
Professional
|
Both
|
$552.00
|
|
|
Service Code
|
HCPCS 36902
|
| Min. Negotiated Rate |
$148.89 |
| Max. Negotiated Rate |
$1,793.58 |
| Rate for Payer: Aetna Commercial |
$313.44
|
| Rate for Payer: Aetna Medicare |
$233.91
|
| Rate for Payer: BCBS Complete |
$156.33
|
| Rate for Payer: BCBS MAPPO |
$233.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,793.58
|
| Rate for Payer: BCN Commercial |
$1,774.88
|
| Rate for Payer: BCN Medicare Advantage |
$233.91
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cofinity Commercial |
$313.44
|
| Rate for Payer: Cofinity Commercial |
$336.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.91
|
| Rate for Payer: Healthscope Commercial |
$280.69
|
| Rate for Payer: Healthscope Whirlpool |
$280.69
|
| Rate for Payer: Meridian Medicaid |
$156.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$245.61
|
| Rate for Payer: PACE SWMI |
$233.91
|
| Rate for Payer: PHP Medicare Advantage |
$233.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$371.30
|
| Rate for Payer: Priority Health Medicare |
$233.91
|
| Rate for Payer: Priority Health Narrow Network |
$371.30
|
| Rate for Payer: UHC Medicare Advantage |
$240.93
|
|
|
PR INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY
|
Professional
|
Both
|
$732.00
|
|
|
Service Code
|
HCPCS 36013
|
| Min. Negotiated Rate |
$78.17 |
| Max. Negotiated Rate |
$1,157.67 |
| Rate for Payer: Aetna Commercial |
$163.72
|
| Rate for Payer: Aetna Medicare |
$122.18
|
| Rate for Payer: BCBS Complete |
$82.08
|
| Rate for Payer: BCBS MAPPO |
$122.18
|
| Rate for Payer: BCBS Trust/PPO |
$800.37
|
| Rate for Payer: BCN Commercial |
$1,157.67
|
| Rate for Payer: BCN Medicare Advantage |
$122.18
|
| Rate for Payer: Cash Price |
$585.60
|
| Rate for Payer: Cash Price |
$585.60
|
| Rate for Payer: Cofinity Commercial |
$175.94
|
| Rate for Payer: Cofinity Commercial |
$163.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.18
|
| Rate for Payer: Healthscope Commercial |
$146.62
|
| Rate for Payer: Healthscope Whirlpool |
$146.62
|
| Rate for Payer: Meridian Medicaid |
$82.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$128.29
|
| Rate for Payer: PACE SWMI |
$122.18
|
| Rate for Payer: PHP Medicare Advantage |
$122.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$194.17
|
| Rate for Payer: Priority Health Medicare |
$122.18
|
| Rate for Payer: Priority Health Narrow Network |
$194.17
|
| Rate for Payer: UHC Medicare Advantage |
$125.85
|
|
|
PR INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA
|
Professional
|
Both
|
$955.00
|
|
|
Service Code
|
HCPCS 36010
|
| Min. Negotiated Rate |
$67.52 |
| Max. Negotiated Rate |
$1,275.84 |
| Rate for Payer: Aetna Commercial |
$142.38
|
| Rate for Payer: Aetna Medicare |
$106.25
|
| Rate for Payer: BCBS Complete |
$70.90
|
| Rate for Payer: BCBS MAPPO |
$106.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,275.84
|
| Rate for Payer: BCN Commercial |
$796.06
|
| Rate for Payer: BCN Medicare Advantage |
$106.25
|
| Rate for Payer: Cash Price |
$764.00
|
| Rate for Payer: Cash Price |
$764.00
|
| Rate for Payer: Cofinity Commercial |
$153.00
|
| Rate for Payer: Cofinity Commercial |
$142.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.25
|
| Rate for Payer: Healthscope Commercial |
$127.50
|
| Rate for Payer: Healthscope Whirlpool |
$127.50
|
| Rate for Payer: Meridian Medicaid |
$70.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$111.56
|
| Rate for Payer: PACE SWMI |
$106.25
|
| Rate for Payer: PHP Medicare Advantage |
$106.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$668.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.09
|
| Rate for Payer: Priority Health Medicare |
$106.25
|
| Rate for Payer: Priority Health Narrow Network |
$168.09
|
| Rate for Payer: UHC Medicare Advantage |
$109.44
|
|
|
PR INTRODUCTION CATHETER AORTA
|
Professional
|
Both
|
$565.00
|
|
|
Service Code
|
HCPCS 36200
|
| Min. Negotiated Rate |
$86.69 |
| Max. Negotiated Rate |
$1,527.32 |
| Rate for Payer: Aetna Commercial |
$183.15
|
| Rate for Payer: Aetna Medicare |
$136.68
|
| Rate for Payer: BCBS Complete |
$91.02
|
| Rate for Payer: BCBS MAPPO |
$136.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,527.32
|
| Rate for Payer: BCN Commercial |
$870.82
|
| Rate for Payer: BCN Medicare Advantage |
$136.68
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cofinity Commercial |
$196.82
|
| Rate for Payer: Cofinity Commercial |
$183.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.68
|
| Rate for Payer: Healthscope Commercial |
$164.02
|
| Rate for Payer: Healthscope Whirlpool |
$164.02
|
| Rate for Payer: Meridian Medicaid |
$91.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$143.51
|
| Rate for Payer: PACE SWMI |
$136.68
|
| Rate for Payer: PHP Medicare Advantage |
$136.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$86.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$395.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.44
|
| Rate for Payer: Priority Health Medicare |
$136.68
|
| Rate for Payer: Priority Health Narrow Network |
$215.44
|
| Rate for Payer: UHC Medicare Advantage |
$140.78
|
|
|
PR INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 44500
|
| Min. Negotiated Rate |
$11.93 |
| Max. Negotiated Rate |
$1,612.90 |
| Rate for Payer: Aetna Commercial |
$25.46
|
| Rate for Payer: Aetna Medicare |
$19.00
|
| Rate for Payer: BCBS Complete |
$12.53
|
| Rate for Payer: BCBS MAPPO |
$19.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,612.90
|
| Rate for Payer: BCN Commercial |
$27.85
|
| Rate for Payer: BCN Medicare Advantage |
$19.00
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Commercial |
$27.36
|
| Rate for Payer: Cofinity Commercial |
$25.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.00
|
| Rate for Payer: Healthscope Commercial |
$22.80
|
| Rate for Payer: Healthscope Whirlpool |
$22.80
|
| Rate for Payer: Meridian Medicaid |
$12.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.95
|
| Rate for Payer: PACE SWMI |
$19.00
|
| Rate for Payer: PHP Medicare Advantage |
$19.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.52
|
| Rate for Payer: Priority Health Medicare |
$19.00
|
| Rate for Payer: Priority Health Narrow Network |
$33.52
|
| Rate for Payer: UHC Medicare Advantage |
$19.57
|
|
|
PR INTRODUCTION NEEDLE/INTRACATHETER VEIN
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 36000
|
| Min. Negotiated Rate |
$11.94 |
| Max. Negotiated Rate |
$772.37 |
| Rate for Payer: Aetna Commercial |
$11.94
|
| Rate for Payer: BCBS Complete |
$70.40
|
| Rate for Payer: BCBS Trust/PPO |
$772.37
|
| Rate for Payer: BCN Commercial |
$35.73
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.36
|
| Rate for Payer: Priority Health Narrow Network |
$14.36
|
|
|
PR INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY
|
Professional
|
Both
|
$721.00
|
|
|
Service Code
|
HCPCS 36100
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$1,575.39 |
| Rate for Payer: Aetna Commercial |
$203.22
|
| Rate for Payer: Aetna Medicare |
$151.66
|
| Rate for Payer: BCBS Complete |
$99.53
|
| Rate for Payer: BCBS MAPPO |
$151.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,575.39
|
| Rate for Payer: BCN Commercial |
$827.33
|
| Rate for Payer: BCN Medicare Advantage |
$151.66
|
| Rate for Payer: Cash Price |
$576.80
|
| Rate for Payer: Cash Price |
$576.80
|
| Rate for Payer: Cofinity Commercial |
$203.22
|
| Rate for Payer: Cofinity Commercial |
$218.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.66
|
| Rate for Payer: Healthscope Commercial |
$181.99
|
| Rate for Payer: Healthscope Whirlpool |
$181.99
|
| Rate for Payer: Meridian Medicaid |
$99.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$159.24
|
| Rate for Payer: PACE SWMI |
$151.66
|
| Rate for Payer: PHP Medicare Advantage |
$151.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$239.38
|
| Rate for Payer: Priority Health Medicare |
$151.66
|
| Rate for Payer: Priority Health Narrow Network |
$239.38
|
| Rate for Payer: UHC Medicare Advantage |
$156.21
|
|
|
PR INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY
|
Professional
|
Both
|
$924.00
|
|
|
Service Code
|
HCPCS 36140
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$1,951.54 |
| Rate for Payer: Aetna Commercial |
$117.29
|
| Rate for Payer: Aetna Medicare |
$87.53
|
| Rate for Payer: BCBS Complete |
$58.15
|
| Rate for Payer: BCBS MAPPO |
$87.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,951.54
|
| Rate for Payer: BCN Commercial |
$749.63
|
| Rate for Payer: BCN Medicare Advantage |
$87.53
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$126.04
|
| Rate for Payer: Cofinity Commercial |
$117.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.53
|
| Rate for Payer: Healthscope Commercial |
$105.04
|
| Rate for Payer: Healthscope Whirlpool |
$105.04
|
| Rate for Payer: Meridian Medicaid |
$58.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.91
|
| Rate for Payer: PACE SWMI |
$87.53
|
| Rate for Payer: PHP Medicare Advantage |
$87.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$646.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.31
|
| Rate for Payer: Priority Health Medicare |
$87.53
|
| Rate for Payer: Priority Health Narrow Network |
$138.31
|
| Rate for Payer: UHC Medicare Advantage |
$90.16
|
|
|
PR INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ
|
Professional
|
Both
|
$2,909.00
|
|
|
Service Code
|
HCPCS 44615
|
| Min. Negotiated Rate |
$190.72 |
| Max. Negotiated Rate |
$2,036.30 |
| Rate for Payer: Aetna Commercial |
$1,414.68
|
| Rate for Payer: Aetna Medicare |
$1,055.73
|
| Rate for Payer: BCBS Complete |
$714.34
|
| Rate for Payer: BCBS MAPPO |
$1,055.73
|
| Rate for Payer: BCBS Trust/PPO |
$190.72
|
| Rate for Payer: BCN Commercial |
$1,550.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,055.73
|
| Rate for Payer: Cash Price |
$2,327.20
|
| Rate for Payer: Cash Price |
$2,327.20
|
| Rate for Payer: Cofinity Commercial |
$1,520.25
|
| Rate for Payer: Cofinity Commercial |
$1,414.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,055.73
|
| Rate for Payer: Healthscope Commercial |
$1,266.88
|
| Rate for Payer: Healthscope Whirlpool |
$1,266.88
|
| Rate for Payer: Meridian Medicaid |
$714.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,108.52
|
| Rate for Payer: PACE SWMI |
$1,055.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,055.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$680.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,036.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,865.64
|
| Rate for Payer: Priority Health Medicare |
$1,055.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,865.64
|
| Rate for Payer: UHC Medicare Advantage |
$1,087.40
|
|
|
PR INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE
|
Professional
|
Both
|
$357.00
|
|
|
Service Code
|
HCPCS 31500
|
| Min. Negotiated Rate |
$88.82 |
| Max. Negotiated Rate |
$1,530.49 |
| Rate for Payer: Aetna Commercial |
$187.85
|
| Rate for Payer: Aetna Medicare |
$140.19
|
| Rate for Payer: BCBS Complete |
$93.26
|
| Rate for Payer: BCBS MAPPO |
$140.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,530.49
|
| Rate for Payer: BCN Commercial |
$203.78
|
| Rate for Payer: BCN Medicare Advantage |
$140.19
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$201.87
|
| Rate for Payer: Cofinity Commercial |
$187.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.19
|
| Rate for Payer: Healthscope Commercial |
$168.23
|
| Rate for Payer: Healthscope Whirlpool |
$168.23
|
| Rate for Payer: Meridian Medicaid |
$93.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.20
|
| Rate for Payer: PACE SWMI |
$140.19
|
| Rate for Payer: PHP Medicare Advantage |
$140.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$249.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.09
|
| Rate for Payer: Priority Health Medicare |
$140.19
|
| Rate for Payer: Priority Health Narrow Network |
$193.09
|
| Rate for Payer: UHC Medicare Advantage |
$144.40
|
|
|
PR IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 95940
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$595.92 |
| Rate for Payer: Aetna Commercial |
$42.02
|
| Rate for Payer: Aetna Medicare |
$31.36
|
| Rate for Payer: BCBS Complete |
$21.25
|
| Rate for Payer: BCBS MAPPO |
$31.36
|
| Rate for Payer: BCBS Trust/PPO |
$595.92
|
| Rate for Payer: BCN Commercial |
$46.43
|
| Rate for Payer: BCN Medicare Advantage |
$31.36
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$42.02
|
| Rate for Payer: Cofinity Commercial |
$45.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.36
|
| Rate for Payer: Healthscope Commercial |
$37.63
|
| Rate for Payer: Healthscope Whirlpool |
$37.63
|
| Rate for Payer: Meridian Medicaid |
$21.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.93
|
| Rate for Payer: PACE SWMI |
$31.36
|
| Rate for Payer: PHP Medicare Advantage |
$31.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.66
|
| Rate for Payer: Priority Health Medicare |
$31.36
|
| Rate for Payer: Priority Health Narrow Network |
$42.66
|
| Rate for Payer: UHC Medicare Advantage |
$32.30
|
|
|
PR IONM REMOTE/NEARBY/>1 PATIENT IN OR PER HOUR
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 95941
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$299.74 |
| Rate for Payer: Aetna Commercial |
$299.74
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS Trust/PPO |
$126.79
|
| Rate for Payer: BCN Commercial |
$104.76
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES
|
Professional
|
Both
|
$341.00
|
|
|
Service Code
|
HCPCS 99255
|
| Min. Negotiated Rate |
$75.02 |
| Max. Negotiated Rate |
$269.75 |
| Rate for Payer: Aetna Commercial |
$208.05
|
| Rate for Payer: BCBS Complete |
$123.68
|
| Rate for Payer: BCBS Trust/PPO |
$75.02
|
| Rate for Payer: BCN Commercial |
$269.75
|
| Rate for Payer: Cash Price |
$272.80
|
| Rate for Payer: Cash Price |
$272.80
|
| Rate for Payer: Meridian Medicaid |
$123.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.44
|
| Rate for Payer: Priority Health Narrow Network |
$236.44
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT LOW MDM 45 MINUTES
|
Professional
|
Both
|
$205.00
|
|
|
Service Code
|
HCPCS 99253
|
| Min. Negotiated Rate |
$63.05 |
| Max. Negotiated Rate |
$286.87 |
| Rate for Payer: Aetna Commercial |
$119.14
|
| Rate for Payer: BCBS Complete |
$66.20
|
| Rate for Payer: BCBS Trust/PPO |
$286.87
|
| Rate for Payer: BCN Commercial |
$144.65
|
| Rate for Payer: Cash Price |
$164.00
|
| Rate for Payer: Cash Price |
$164.00
|
| Rate for Payer: Meridian Medicaid |
$66.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.79
|
| Rate for Payer: Priority Health Narrow Network |
$126.79
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT MOD MDM 60 MINUTES
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 99254
|
| Min. Negotiated Rate |
$87.54 |
| Max. Negotiated Rate |
$245.66 |
| Rate for Payer: Aetna Commercial |
$172.55
|
| Rate for Payer: BCBS Complete |
$91.92
|
| Rate for Payer: BCBS Trust/PPO |
$245.66
|
| Rate for Payer: BCN Commercial |
$201.34
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Meridian Medicaid |
$91.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.47
|
| Rate for Payer: Priority Health Narrow Network |
$176.47
|
|
