|
PR COMPRE EP EVAL W/L ATRIAL PACG&REC C SINS/L ATR
|
Professional
|
Both
|
$252.00
|
|
|
Service Code
|
HCPCS 93621
|
| Min. Negotiated Rate |
$150.99 |
| Max. Negotiated Rate |
$1,658.64 |
| Rate for Payer: Aetna Commercial |
$205.99
|
| Rate for Payer: BCN Commercial |
$1,658.64
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$150.99
|
| Rate for Payer: Priority Health Narrow Network |
$150.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$586.33
|
| Rate for Payer: UHC Exchange |
$586.33
|
|
|
PR CONDITIONING PLAY AUDIOMETRY
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 92582
|
| Min. Negotiated Rate |
$79.36 |
| Max. Negotiated Rate |
$133.46 |
| Rate for Payer: Aetna Commercial |
$106.34
|
| Rate for Payer: Aetna Medicare |
$79.36
|
| Rate for Payer: BCBS MAPPO |
$79.36
|
| Rate for Payer: BCN Commercial |
$133.46
|
| Rate for Payer: BCN Medicare Advantage |
$79.36
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$114.28
|
| Rate for Payer: Cofinity Commercial |
$106.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.36
|
| Rate for Payer: Healthscope Commercial |
$95.23
|
| Rate for Payer: Healthscope Whirlpool |
$95.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$87.30
|
| Rate for Payer: Nomi Health Commercial |
$95.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.25
|
| Rate for Payer: PACE SWMI |
$79.36
|
| Rate for Payer: PHP Medicare Advantage |
$79.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$123.08
|
| Rate for Payer: Priority Health Medicare |
$79.36
|
| Rate for Payer: Priority Health Narrow Network |
$123.08
|
| Rate for Payer: Railroad Medicare Medicare |
$79.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$79.36
|
| Rate for Payer: UHC Exchange |
$110.16
|
| Rate for Payer: UHCCP DNSP |
$79.36
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC
|
Facility
|
IP
|
$952.00
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
57522
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$714.00 |
| Max. Negotiated Rate |
$952.00 |
| Rate for Payer: Aetna Commercial |
$856.80
|
| Rate for Payer: ASR ASR |
$923.44
|
| Rate for Payer: BCBS Trust/PPO |
$781.78
|
| Rate for Payer: BCN Commercial |
$781.78
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$894.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.60
|
| Rate for Payer: Healthscope Commercial |
$923.44
|
| Rate for Payer: Healthscope Whirlpool |
$952.00
|
| Rate for Payer: Mclaren Commercial |
$856.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.20
|
| Rate for Payer: Nomi Health Commercial |
$780.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$714.00
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 57522
|
| Min. Negotiated Rate |
$147.61 |
| Max. Negotiated Rate |
$714.00 |
| Rate for Payer: Aetna Commercial |
$303.31
|
| Rate for Payer: Aetna Medicare |
$226.35
|
| Rate for Payer: BCBS Complete |
$154.99
|
| Rate for Payer: BCBS MAPPO |
$226.35
|
| Rate for Payer: BCN Commercial |
$384.94
|
| Rate for Payer: BCN Medicare Advantage |
$226.35
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$325.94
|
| Rate for Payer: Cofinity Commercial |
$303.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.35
|
| Rate for Payer: Healthscope Commercial |
$271.62
|
| Rate for Payer: Healthscope Whirlpool |
$271.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.67
|
| Rate for Payer: Meridian Medicaid |
$154.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$248.99
|
| Rate for Payer: Nomi Health Commercial |
$271.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$714.00
|
| Rate for Payer: PACE SWMI |
$226.35
|
| Rate for Payer: PHP Medicare Advantage |
$226.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$389.86
|
| Rate for Payer: Priority Health Medicare |
$226.35
|
| Rate for Payer: Priority Health Narrow Network |
$389.86
|
| Rate for Payer: Railroad Medicare Medicare |
$226.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$436.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$226.35
|
| Rate for Payer: UHC Exchange |
$436.86
|
| Rate for Payer: UHC Medicaid |
$147.61
|
| Rate for Payer: UHCCP DNSP |
$226.35
|
| Rate for Payer: UHCCP Medicaid |
$147.61
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC
|
Facility
|
OP
|
$952.00
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
57522
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$293.81 |
| Max. Negotiated Rate |
$4,031.86 |
| Rate for Payer: Aetna Commercial |
$856.80
|
| Rate for Payer: Aetna Medicare |
$3,225.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: ASR ASR |
$923.44
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$784.92
|
| Rate for Payer: BCCCP Commercial |
$293.81
|
| Rate for Payer: BCN Commercial |
$784.92
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$894.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$923.44
|
| Rate for Payer: Healthscope Whirlpool |
$952.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,225.49
|
| Rate for Payer: Mclaren Commercial |
$856.80
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$1,771.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.20
|
| Rate for Payer: Nomi Health Commercial |
$780.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$714.00
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$3,548.04
|
| Rate for Payer: PHP Medicaid |
$1,728.86
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$834.14
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health Narrow Network |
$667.35
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP DNSP |
$3,225.49
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: VA VA |
$3,225.49
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC
|
Professional
|
Both
|
$952.00
|
|
|
Service Code
|
HCPCS 57522
|
| Hospital Charge Code |
57522
|
| Min. Negotiated Rate |
$147.61 |
| Max. Negotiated Rate |
$714.00 |
| Rate for Payer: Aetna Commercial |
$303.31
|
| Rate for Payer: Aetna Medicare |
$226.35
|
| Rate for Payer: BCBS Complete |
$154.99
|
| Rate for Payer: BCBS MAPPO |
$226.35
|
| Rate for Payer: BCN Commercial |
$384.94
|
| Rate for Payer: BCN Medicare Advantage |
$226.35
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cofinity Commercial |
$325.94
|
| Rate for Payer: Cofinity Commercial |
$303.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.35
|
| Rate for Payer: Healthscope Commercial |
$271.62
|
| Rate for Payer: Healthscope Whirlpool |
$271.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.67
|
| Rate for Payer: Meridian Medicaid |
$154.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$248.99
|
| Rate for Payer: Nomi Health Commercial |
$271.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$714.00
|
| Rate for Payer: PACE SWMI |
$226.35
|
| Rate for Payer: PHP Medicare Advantage |
$226.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$147.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$389.86
|
| Rate for Payer: Priority Health Medicare |
$226.35
|
| Rate for Payer: Priority Health Narrow Network |
$389.86
|
| Rate for Payer: Railroad Medicare Medicare |
$226.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$436.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$226.35
|
| Rate for Payer: UHC Exchange |
$436.86
|
| Rate for Payer: UHC Medicaid |
$147.61
|
| Rate for Payer: UHCCP DNSP |
$226.35
|
| Rate for Payer: UHCCP Medicaid |
$147.61
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER
|
Professional
|
Both
|
$1,070.00
|
|
|
Service Code
|
HCPCS 57520
|
| Min. Negotiated Rate |
$174.45 |
| Max. Negotiated Rate |
$802.50 |
| Rate for Payer: Aetna Commercial |
$357.93
|
| Rate for Payer: Aetna Medicare |
$267.11
|
| Rate for Payer: BCBS Complete |
$183.17
|
| Rate for Payer: BCBS MAPPO |
$267.11
|
| Rate for Payer: BCN Commercial |
$447.69
|
| Rate for Payer: BCN Medicare Advantage |
$267.11
|
| Rate for Payer: Cash Price |
$856.00
|
| Rate for Payer: Cash Price |
$856.00
|
| Rate for Payer: Cofinity Commercial |
$384.64
|
| Rate for Payer: Cofinity Commercial |
$357.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.11
|
| Rate for Payer: Healthscope Commercial |
$320.53
|
| Rate for Payer: Healthscope Whirlpool |
$320.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$280.47
|
| Rate for Payer: Meridian Medicaid |
$183.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$293.82
|
| Rate for Payer: Nomi Health Commercial |
$320.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$802.50
|
| Rate for Payer: PACE SWMI |
$267.11
|
| Rate for Payer: PHP Medicare Advantage |
$267.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$453.42
|
| Rate for Payer: Priority Health Medicare |
$267.11
|
| Rate for Payer: Priority Health Narrow Network |
$453.42
|
| Rate for Payer: Railroad Medicare Medicare |
$267.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$498.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$267.11
|
| Rate for Payer: UHC Exchange |
$498.14
|
| Rate for Payer: UHC Medicaid |
$174.45
|
| Rate for Payer: UHCCP DNSP |
$267.11
|
| Rate for Payer: UHCCP Medicaid |
$174.45
|
|
|
PR CONSTRUCTION ARTIFICIAL VAGINA W/O GRAFT
|
Professional
|
Both
|
$1,752.00
|
|
|
Service Code
|
HCPCS 57291
|
| Min. Negotiated Rate |
$311.41 |
| Max. Negotiated Rate |
$1,314.00 |
| Rate for Payer: Aetna Commercial |
$644.42
|
| Rate for Payer: Aetna Medicare |
$480.91
|
| Rate for Payer: BCBS Complete |
$326.98
|
| Rate for Payer: BCBS MAPPO |
$480.91
|
| Rate for Payer: BCN Commercial |
$826.15
|
| Rate for Payer: BCN Medicare Advantage |
$480.91
|
| Rate for Payer: Cash Price |
$1,401.60
|
| Rate for Payer: Cash Price |
$1,401.60
|
| Rate for Payer: Cofinity Commercial |
$644.42
|
| Rate for Payer: Cofinity Commercial |
$692.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$480.91
|
| Rate for Payer: Healthscope Commercial |
$577.09
|
| Rate for Payer: Healthscope Whirlpool |
$577.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$504.96
|
| Rate for Payer: Meridian Medicaid |
$326.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$529.00
|
| Rate for Payer: Nomi Health Commercial |
$577.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,314.00
|
| Rate for Payer: PACE SWMI |
$480.91
|
| Rate for Payer: PHP Medicare Advantage |
$480.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$311.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$836.71
|
| Rate for Payer: Priority Health Medicare |
$480.91
|
| Rate for Payer: Priority Health Narrow Network |
$836.71
|
| Rate for Payer: Railroad Medicare Medicare |
$480.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$954.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$480.91
|
| Rate for Payer: UHC Exchange |
$954.13
|
| Rate for Payer: UHC Medicaid |
$311.41
|
| Rate for Payer: UHCCP DNSP |
$480.91
|
| Rate for Payer: UHCCP Medicaid |
$311.41
|
|
|
PR CONSULTS
|
Professional
|
Both
|
$525.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$393.75 |
| Rate for Payer: BCBS Complete |
$210.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$393.75
|
|
|
PR CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPMENT
|
Professional
|
Both
|
$282.00
|
|
|
Service Code
|
HCPCS 95250
|
| Min. Negotiated Rate |
$139.72 |
| Max. Negotiated Rate |
$225.13 |
| Rate for Payer: Aetna Commercial |
$187.22
|
| Rate for Payer: Aetna Medicare |
$139.72
|
| Rate for Payer: BCBS MAPPO |
$139.72
|
| Rate for Payer: BCN Commercial |
$214.63
|
| Rate for Payer: BCN Medicare Advantage |
$139.72
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$187.22
|
| Rate for Payer: Cofinity Commercial |
$201.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.72
|
| Rate for Payer: Healthscope Commercial |
$167.66
|
| Rate for Payer: Healthscope Whirlpool |
$167.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$153.69
|
| Rate for Payer: Nomi Health Commercial |
$167.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$211.50
|
| Rate for Payer: PACE SWMI |
$139.72
|
| Rate for Payer: PHP Medicare Advantage |
$139.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$197.93
|
| Rate for Payer: Priority Health Medicare |
$139.72
|
| Rate for Payer: Priority Health Narrow Network |
$197.93
|
| Rate for Payer: Railroad Medicare Medicare |
$139.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$225.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$139.72
|
| Rate for Payer: UHC Exchange |
$225.13
|
| Rate for Payer: UHCCP DNSP |
$139.72
|
|
|
PR CONT GLUC MONITORING PATIENT PROVIDED EQUIPMENT
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 95249
|
| Min. Negotiated Rate |
$64.02 |
| Max. Negotiated Rate |
$98.60 |
| Rate for Payer: Aetna Commercial |
$85.79
|
| Rate for Payer: Aetna Medicare |
$64.02
|
| Rate for Payer: BCBS MAPPO |
$64.02
|
| Rate for Payer: BCN Commercial |
$98.60
|
| Rate for Payer: BCN Medicare Advantage |
$64.02
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$85.79
|
| Rate for Payer: Cofinity Commercial |
$92.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.02
|
| Rate for Payer: Healthscope Commercial |
$76.82
|
| Rate for Payer: Healthscope Whirlpool |
$76.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$70.42
|
| Rate for Payer: Nomi Health Commercial |
$76.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.25
|
| Rate for Payer: PACE SWMI |
$64.02
|
| Rate for Payer: PHP Medicare Advantage |
$64.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$90.94
|
| Rate for Payer: Priority Health Medicare |
$64.02
|
| Rate for Payer: Priority Health Narrow Network |
$90.94
|
| Rate for Payer: Railroad Medicare Medicare |
$64.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$64.02
|
| Rate for Payer: UHC Exchange |
$82.01
|
| Rate for Payer: UHCCP DNSP |
$64.02
|
|
|
PR CONTINENT DVRJ W/INT ANAST ANY SGM SM&/LG INTSTN
|
Professional
|
Both
|
$3,537.00
|
|
|
Service Code
|
HCPCS 50825
|
| Min. Negotiated Rate |
$933.79 |
| Max. Negotiated Rate |
$2,933.27 |
| Rate for Payer: Aetna Commercial |
$1,945.13
|
| Rate for Payer: Aetna Medicare |
$1,451.59
|
| Rate for Payer: BCBS Complete |
$980.48
|
| Rate for Payer: BCBS MAPPO |
$1,451.59
|
| Rate for Payer: BCN Commercial |
$2,448.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,451.59
|
| Rate for Payer: Cash Price |
$2,829.60
|
| Rate for Payer: Cash Price |
$2,829.60
|
| Rate for Payer: Cofinity Commercial |
$2,090.29
|
| Rate for Payer: Cofinity Commercial |
$1,945.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,451.59
|
| Rate for Payer: Healthscope Commercial |
$1,741.91
|
| Rate for Payer: Healthscope Whirlpool |
$1,741.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,524.17
|
| Rate for Payer: Meridian Medicaid |
$980.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,596.75
|
| Rate for Payer: Nomi Health Commercial |
$1,741.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,652.75
|
| Rate for Payer: PACE SWMI |
$1,451.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,451.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$933.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,666.74
|
| Rate for Payer: Priority Health Medicare |
$1,451.59
|
| Rate for Payer: Priority Health Narrow Network |
$2,666.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,451.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,933.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,451.59
|
| Rate for Payer: UHC Exchange |
$2,933.27
|
| Rate for Payer: UHC Medicaid |
$933.79
|
| Rate for Payer: UHCCP DNSP |
$1,451.59
|
| Rate for Payer: UHCCP Medicaid |
$933.79
|
|
|
PR CONTINENT ILEOSTOMY KOCK PROCEDURE SPX
|
Professional
|
Both
|
$4,162.00
|
|
|
Service Code
|
HCPCS 44316
|
| Min. Negotiated Rate |
$844.55 |
| Max. Negotiated Rate |
$3,121.50 |
| Rate for Payer: Aetna Commercial |
$1,769.34
|
| Rate for Payer: Aetna Medicare |
$1,320.40
|
| Rate for Payer: BCBS Complete |
$886.78
|
| Rate for Payer: BCBS MAPPO |
$1,320.40
|
| Rate for Payer: BCN Commercial |
$2,125.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,320.40
|
| Rate for Payer: Cash Price |
$3,329.60
|
| Rate for Payer: Cash Price |
$3,329.60
|
| Rate for Payer: Cofinity Commercial |
$1,901.38
|
| Rate for Payer: Cofinity Commercial |
$1,769.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,320.40
|
| Rate for Payer: Healthscope Commercial |
$1,584.48
|
| Rate for Payer: Healthscope Whirlpool |
$1,584.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,386.42
|
| Rate for Payer: Meridian Medicaid |
$886.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,452.44
|
| Rate for Payer: Nomi Health Commercial |
$1,584.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,121.50
|
| Rate for Payer: PACE SWMI |
$1,320.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,320.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$844.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,589.64
|
| Rate for Payer: Priority Health Medicare |
$1,320.40
|
| Rate for Payer: Priority Health Narrow Network |
$2,589.64
|
| Rate for Payer: Railroad Medicare Medicare |
$1,320.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,526.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,320.40
|
| Rate for Payer: UHC Exchange |
$2,526.81
|
| Rate for Payer: UHC Medicaid |
$844.55
|
| Rate for Payer: UHCCP DNSP |
$1,320.40
|
| Rate for Payer: UHCCP Medicaid |
$844.55
|
|
|
PR CONT INTRAOP NEURO MONITOR
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS G0453
|
| Min. Negotiated Rate |
$27.11 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Commercial |
$36.33
|
| Rate for Payer: Aetna Medicare |
$27.11
|
| Rate for Payer: BCBS Complete |
$52.80
|
| Rate for Payer: BCBS MAPPO |
$27.11
|
| Rate for Payer: BCN Commercial |
$46.81
|
| Rate for Payer: BCN Medicare Advantage |
$27.11
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$39.04
|
| Rate for Payer: Cofinity Commercial |
$36.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.11
|
| Rate for Payer: Healthscope Commercial |
$32.53
|
| Rate for Payer: Healthscope Whirlpool |
$32.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.82
|
| Rate for Payer: Nomi Health Commercial |
$32.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.00
|
| Rate for Payer: PACE SWMI |
$27.11
|
| Rate for Payer: PHP Medicare Advantage |
$27.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$43.18
|
| Rate for Payer: Priority Health Medicare |
$27.11
|
| Rate for Payer: Priority Health Narrow Network |
$43.18
|
| Rate for Payer: Railroad Medicare Medicare |
$27.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.11
|
| Rate for Payer: UHC Exchange |
$53.18
|
| Rate for Payer: UHCCP DNSP |
$27.11
|
|
|
PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R
|
Professional
|
Both
|
$76.00
|
|
|
Service Code
|
HCPCS 95251
|
| Min. Negotiated Rate |
$22.37 |
| Max. Negotiated Rate |
$57.93 |
| Rate for Payer: Aetna Commercial |
$46.04
|
| Rate for Payer: Aetna Medicare |
$34.36
|
| Rate for Payer: BCBS Complete |
$23.49
|
| Rate for Payer: BCBS MAPPO |
$34.36
|
| Rate for Payer: BCN Commercial |
$51.29
|
| Rate for Payer: BCN Medicare Advantage |
$34.36
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cash Price |
$60.80
|
| Rate for Payer: Cofinity Commercial |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$46.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.36
|
| Rate for Payer: Healthscope Commercial |
$41.23
|
| Rate for Payer: Healthscope Whirlpool |
$41.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.08
|
| Rate for Payer: Meridian Medicaid |
$23.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.80
|
| Rate for Payer: Nomi Health Commercial |
$41.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.00
|
| Rate for Payer: PACE SWMI |
$34.36
|
| Rate for Payer: PHP Medicare Advantage |
$34.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$47.31
|
| Rate for Payer: Priority Health Medicare |
$34.36
|
| Rate for Payer: Priority Health Narrow Network |
$47.31
|
| Rate for Payer: Railroad Medicare Medicare |
$34.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34.36
|
| Rate for Payer: UHC Exchange |
$57.93
|
| Rate for Payer: UHC Medicaid |
$22.37
|
| Rate for Payer: UHCCP DNSP |
$34.36
|
| Rate for Payer: UHCCP Medicaid |
$22.37
|
|
|
PR CONTINUOUS INHALATION TREATMENT 1ST HR
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS 94644
|
| Min. Negotiated Rate |
$57.17 |
| Max. Negotiated Rate |
$86.15 |
| Rate for Payer: Aetna Commercial |
$76.61
|
| Rate for Payer: Aetna Medicare |
$57.17
|
| Rate for Payer: BCBS MAPPO |
$57.17
|
| Rate for Payer: BCN Commercial |
$86.15
|
| Rate for Payer: BCN Medicare Advantage |
$57.17
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cofinity Commercial |
$76.61
|
| Rate for Payer: Cofinity Commercial |
$82.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.17
|
| Rate for Payer: Healthscope Commercial |
$68.60
|
| Rate for Payer: Healthscope Whirlpool |
$68.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.89
|
| Rate for Payer: Nomi Health Commercial |
$68.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.25
|
| Rate for Payer: PACE SWMI |
$57.17
|
| Rate for Payer: PHP Medicare Advantage |
$57.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$79.45
|
| Rate for Payer: Priority Health Medicare |
$57.17
|
| Rate for Payer: Priority Health Narrow Network |
$79.45
|
| Rate for Payer: Railroad Medicare Medicare |
$57.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$80.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57.17
|
| Rate for Payer: UHC Exchange |
$80.32
|
| Rate for Payer: UHCCP DNSP |
$57.17
|
|
|
PR CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 49465
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$54.71 |
| Rate for Payer: Aetna Commercial |
$34.38
|
| Rate for Payer: Aetna Medicare |
$25.66
|
| Rate for Payer: BCBS Complete |
$17.22
|
| Rate for Payer: BCBS MAPPO |
$25.66
|
| Rate for Payer: BCN Commercial |
$44.32
|
| Rate for Payer: BCN Medicare Advantage |
$25.66
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$36.95
|
| Rate for Payer: Cofinity Commercial |
$34.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.66
|
| Rate for Payer: Healthscope Commercial |
$30.79
|
| Rate for Payer: Healthscope Whirlpool |
$30.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.94
|
| Rate for Payer: Meridian Medicaid |
$17.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.23
|
| Rate for Payer: Nomi Health Commercial |
$30.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.00
|
| Rate for Payer: PACE SWMI |
$25.66
|
| Rate for Payer: PHP Medicare Advantage |
$25.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$54.00
|
| Rate for Payer: Priority Health Medicare |
$25.66
|
| Rate for Payer: Priority Health Narrow Network |
$54.00
|
| Rate for Payer: Railroad Medicare Medicare |
$25.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.66
|
| Rate for Payer: UHC Exchange |
$54.71
|
| Rate for Payer: UHC Medicaid |
$16.40
|
| Rate for Payer: UHCCP DNSP |
$25.66
|
| Rate for Payer: UHCCP Medicaid |
$16.40
|
|
|
PR CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX
|
Professional
|
Both
|
$408.00
|
|
|
Service Code
|
HCPCS 30903
|
| Min. Negotiated Rate |
$44.52 |
| Max. Negotiated Rate |
$306.00 |
| Rate for Payer: Aetna Commercial |
$93.95
|
| Rate for Payer: Aetna Medicare |
$70.11
|
| Rate for Payer: BCBS Complete |
$46.75
|
| Rate for Payer: BCBS MAPPO |
$70.11
|
| Rate for Payer: BCN Commercial |
$115.53
|
| Rate for Payer: BCN Medicare Advantage |
$70.11
|
| Rate for Payer: Cash Price |
$326.40
|
| Rate for Payer: Cash Price |
$326.40
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Cofinity Commercial |
$100.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.11
|
| Rate for Payer: Healthscope Commercial |
$84.13
|
| Rate for Payer: Healthscope Whirlpool |
$84.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.62
|
| Rate for Payer: Meridian Medicaid |
$46.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.12
|
| Rate for Payer: Nomi Health Commercial |
$84.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$306.00
|
| Rate for Payer: PACE SWMI |
$70.11
|
| Rate for Payer: PHP Medicare Advantage |
$70.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$108.79
|
| Rate for Payer: Priority Health Medicare |
$70.11
|
| Rate for Payer: Priority Health Narrow Network |
$108.79
|
| Rate for Payer: Railroad Medicare Medicare |
$70.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$140.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$70.11
|
| Rate for Payer: UHC Exchange |
$140.64
|
| Rate for Payer: UHC Medicaid |
$44.52
|
| Rate for Payer: UHCCP DNSP |
$70.11
|
| Rate for Payer: UHCCP Medicaid |
$44.52
|
|
|
PR CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 30901
|
| Min. Negotiated Rate |
$31.74 |
| Max. Negotiated Rate |
$204.00 |
| Rate for Payer: Aetna Commercial |
$66.89
|
| Rate for Payer: Aetna Medicare |
$49.92
|
| Rate for Payer: BCBS Complete |
$33.33
|
| Rate for Payer: BCBS MAPPO |
$49.92
|
| Rate for Payer: BCN Commercial |
$84.16
|
| Rate for Payer: BCN Medicare Advantage |
$49.92
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$71.88
|
| Rate for Payer: Cofinity Commercial |
$66.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.92
|
| Rate for Payer: Healthscope Commercial |
$59.90
|
| Rate for Payer: Healthscope Whirlpool |
$59.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.42
|
| Rate for Payer: Meridian Medicaid |
$33.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.91
|
| Rate for Payer: Nomi Health Commercial |
$59.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.00
|
| Rate for Payer: PACE SWMI |
$49.92
|
| Rate for Payer: PHP Medicare Advantage |
$49.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$79.26
|
| Rate for Payer: Priority Health Medicare |
$49.92
|
| Rate for Payer: Priority Health Narrow Network |
$79.26
|
| Rate for Payer: Railroad Medicare Medicare |
$49.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.92
|
| Rate for Payer: UHC Exchange |
$101.06
|
| Rate for Payer: UHC Medicaid |
$31.74
|
| Rate for Payer: UHCCP DNSP |
$49.92
|
| Rate for Payer: UHCCP Medicaid |
$31.74
|
|
|
PR CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE
|
Professional
|
Both
|
$336.00
|
|
|
Service Code
|
HCPCS 42960
|
| Min. Negotiated Rate |
$92.87 |
| Max. Negotiated Rate |
$297.32 |
| Rate for Payer: Aetna Commercial |
$190.78
|
| Rate for Payer: Aetna Medicare |
$142.37
|
| Rate for Payer: BCBS Complete |
$97.51
|
| Rate for Payer: BCBS MAPPO |
$142.37
|
| Rate for Payer: BCN Commercial |
$244.01
|
| Rate for Payer: BCN Medicare Advantage |
$142.37
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cofinity Commercial |
$205.01
|
| Rate for Payer: Cofinity Commercial |
$190.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.37
|
| Rate for Payer: Healthscope Commercial |
$170.84
|
| Rate for Payer: Healthscope Whirlpool |
$170.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.49
|
| Rate for Payer: Meridian Medicaid |
$97.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$156.61
|
| Rate for Payer: Nomi Health Commercial |
$170.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.00
|
| Rate for Payer: PACE SWMI |
$142.37
|
| Rate for Payer: PHP Medicare Advantage |
$142.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$297.32
|
| Rate for Payer: Priority Health Medicare |
$142.37
|
| Rate for Payer: Priority Health Narrow Network |
$297.32
|
| Rate for Payer: Railroad Medicare Medicare |
$142.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$286.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$142.37
|
| Rate for Payer: UHC Exchange |
$286.16
|
| Rate for Payer: UHC Medicaid |
$92.87
|
| Rate for Payer: UHCCP DNSP |
$142.37
|
| Rate for Payer: UHCCP Medicaid |
$92.87
|
|
|
PR CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ
|
Professional
|
Both
|
$2,159.00
|
|
|
Service Code
|
HCPCS 49446
|
| Min. Negotiated Rate |
$80.51 |
| Max. Negotiated Rate |
$1,619.25 |
| Rate for Payer: Aetna Commercial |
$169.46
|
| Rate for Payer: Aetna Medicare |
$126.46
|
| Rate for Payer: BCBS Complete |
$84.54
|
| Rate for Payer: BCBS MAPPO |
$126.46
|
| Rate for Payer: BCN Commercial |
$214.13
|
| Rate for Payer: BCN Medicare Advantage |
$126.46
|
| Rate for Payer: Cash Price |
$1,727.20
|
| Rate for Payer: Cash Price |
$1,727.20
|
| Rate for Payer: Cofinity Commercial |
$182.10
|
| Rate for Payer: Cofinity Commercial |
$169.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.46
|
| Rate for Payer: Healthscope Commercial |
$151.75
|
| Rate for Payer: Healthscope Whirlpool |
$151.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.78
|
| Rate for Payer: Meridian Medicaid |
$84.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.11
|
| Rate for Payer: Nomi Health Commercial |
$151.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,619.25
|
| Rate for Payer: PACE SWMI |
$126.46
|
| Rate for Payer: PHP Medicare Advantage |
$126.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$80.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$260.91
|
| Rate for Payer: Priority Health Medicare |
$126.46
|
| Rate for Payer: Priority Health Narrow Network |
$260.91
|
| Rate for Payer: Railroad Medicare Medicare |
$126.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$126.46
|
| Rate for Payer: UHC Exchange |
$264.83
|
| Rate for Payer: UHC Medicaid |
$80.51
|
| Rate for Payer: UHCCP DNSP |
$126.46
|
| Rate for Payer: UHCCP Medicaid |
$80.51
|
|
|
PR CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT
|
Professional
|
Both
|
$3,559.00
|
|
|
Service Code
|
HCPCS 27132
|
| Min. Negotiated Rate |
$959.14 |
| Max. Negotiated Rate |
$2,947.72 |
| Rate for Payer: Aetna Commercial |
$1,988.95
|
| Rate for Payer: Aetna Medicare |
$1,484.29
|
| Rate for Payer: BCBS Complete |
$1,007.10
|
| Rate for Payer: BCBS MAPPO |
$1,484.29
|
| Rate for Payer: BCN Commercial |
$2,517.29
|
| Rate for Payer: BCN Medicare Advantage |
$1,484.29
|
| Rate for Payer: Cash Price |
$2,847.20
|
| Rate for Payer: Cash Price |
$2,847.20
|
| Rate for Payer: Cofinity Commercial |
$2,137.38
|
| Rate for Payer: Cofinity Commercial |
$1,988.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,484.29
|
| Rate for Payer: Healthscope Commercial |
$1,781.15
|
| Rate for Payer: Healthscope Whirlpool |
$1,781.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,558.50
|
| Rate for Payer: Meridian Medicaid |
$1,007.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,632.72
|
| Rate for Payer: Nomi Health Commercial |
$1,781.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,669.25
|
| Rate for Payer: PACE SWMI |
$1,484.29
|
| Rate for Payer: PHP Medicare Advantage |
$1,484.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$959.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,690.92
|
| Rate for Payer: Priority Health Medicare |
$1,484.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,690.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,484.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,947.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,484.29
|
| Rate for Payer: UHC Exchange |
$2,947.72
|
| Rate for Payer: UHC Medicaid |
$959.14
|
| Rate for Payer: UHCCP DNSP |
$1,484.29
|
| Rate for Payer: UHCCP Medicaid |
$959.14
|
|
|
PR CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY
|
Professional
|
Both
|
$1,828.00
|
|
|
Service Code
|
HCPCS 23415
|
| Min. Negotiated Rate |
$419.82 |
| Max. Negotiated Rate |
$1,371.00 |
| Rate for Payer: Aetna Commercial |
$858.35
|
| Rate for Payer: Aetna Medicare |
$640.56
|
| Rate for Payer: BCBS Complete |
$440.81
|
| Rate for Payer: BCBS MAPPO |
$640.56
|
| Rate for Payer: BCN Commercial |
$1,072.16
|
| Rate for Payer: BCN Medicare Advantage |
$640.56
|
| Rate for Payer: Cash Price |
$1,462.40
|
| Rate for Payer: Cash Price |
$1,462.40
|
| Rate for Payer: Cofinity Commercial |
$922.41
|
| Rate for Payer: Cofinity Commercial |
$858.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$640.56
|
| Rate for Payer: Healthscope Commercial |
$768.67
|
| Rate for Payer: Healthscope Whirlpool |
$768.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$672.59
|
| Rate for Payer: Meridian Medicaid |
$440.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$704.62
|
| Rate for Payer: Nomi Health Commercial |
$768.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,371.00
|
| Rate for Payer: PACE SWMI |
$640.56
|
| Rate for Payer: PHP Medicare Advantage |
$640.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,146.10
|
| Rate for Payer: Priority Health Medicare |
$640.56
|
| Rate for Payer: Priority Health Narrow Network |
$1,146.10
|
| Rate for Payer: Railroad Medicare Medicare |
$640.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,214.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$640.56
|
| Rate for Payer: UHC Exchange |
$1,214.29
|
| Rate for Payer: UHC Medicaid |
$419.82
|
| Rate for Payer: UHCCP DNSP |
$640.56
|
| Rate for Payer: UHCCP Medicaid |
$419.82
|
|
|
PR CORDOCENTESIS INTRAUTERINE
|
Professional
|
Both
|
$552.00
|
|
|
Service Code
|
HCPCS 59012
|
| Min. Negotiated Rate |
$114.59 |
| Max. Negotiated Rate |
$414.00 |
| Rate for Payer: Aetna Commercial |
$243.33
|
| Rate for Payer: Aetna Medicare |
$181.59
|
| Rate for Payer: BCBS Complete |
$120.32
|
| Rate for Payer: BCBS MAPPO |
$181.59
|
| Rate for Payer: BCN Commercial |
$300.28
|
| Rate for Payer: BCN Medicare Advantage |
$181.59
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cash Price |
$441.60
|
| Rate for Payer: Cofinity Commercial |
$261.49
|
| Rate for Payer: Cofinity Commercial |
$243.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.59
|
| Rate for Payer: Healthscope Commercial |
$217.91
|
| Rate for Payer: Healthscope Whirlpool |
$217.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$190.67
|
| Rate for Payer: Meridian Medicaid |
$120.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$199.75
|
| Rate for Payer: Nomi Health Commercial |
$217.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$414.00
|
| Rate for Payer: PACE SWMI |
$181.59
|
| Rate for Payer: PHP Medicare Advantage |
$181.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$283.47
|
| Rate for Payer: Priority Health Medicare |
$181.59
|
| Rate for Payer: Priority Health Narrow Network |
$283.47
|
| Rate for Payer: Railroad Medicare Medicare |
$181.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$360.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$181.59
|
| Rate for Payer: UHC Exchange |
$360.65
|
| Rate for Payer: UHC Medicaid |
$114.59
|
| Rate for Payer: UHCCP DNSP |
$181.59
|
| Rate for Payer: UHCCP Medicaid |
$114.59
|
|
|
PR CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG
|
Professional
|
Both
|
$381.00
|
|
|
Service Code
|
HCPCS 32408
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$285.75 |
| Rate for Payer: Aetna Commercial |
$175.14
|
| Rate for Payer: Aetna Medicare |
$130.70
|
| Rate for Payer: BCBS Complete |
$87.44
|
| Rate for Payer: BCBS MAPPO |
$130.70
|
| Rate for Payer: BCN Commercial |
$222.60
|
| Rate for Payer: BCN Medicare Advantage |
$130.70
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cash Price |
$304.80
|
| Rate for Payer: Cofinity Commercial |
$188.21
|
| Rate for Payer: Cofinity Commercial |
$175.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$130.70
|
| Rate for Payer: Healthscope Commercial |
$156.84
|
| Rate for Payer: Healthscope Whirlpool |
$156.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.24
|
| Rate for Payer: Meridian Medicaid |
$87.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$143.77
|
| Rate for Payer: Nomi Health Commercial |
$156.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$285.75
|
| Rate for Payer: PACE SWMI |
$130.70
|
| Rate for Payer: PHP Medicare Advantage |
$130.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$209.62
|
| Rate for Payer: Priority Health Medicare |
$130.70
|
| Rate for Payer: Priority Health Narrow Network |
$209.62
|
| Rate for Payer: Railroad Medicare Medicare |
$130.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$273.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$130.70
|
| Rate for Payer: UHC Exchange |
$273.56
|
| Rate for Payer: UHC Medicaid |
$83.28
|
| Rate for Payer: UHCCP DNSP |
$130.70
|
| Rate for Payer: UHCCP Medicaid |
$83.28
|
|
