|
PR MAXILLECTOMY W/O ORBITAL EXENTERATION
|
Professional
|
Both
|
$3,239.00
|
|
|
Service Code
|
HCPCS 31225
|
| Min. Negotiated Rate |
$904.98 |
| Max. Negotiated Rate |
$2,643.74 |
| Rate for Payer: Aetna Commercial |
$2,374.13
|
| Rate for Payer: Aetna Medicare |
$1,771.74
|
| Rate for Payer: BCBS Complete |
$1,209.27
|
| Rate for Payer: BCBS MAPPO |
$1,771.74
|
| Rate for Payer: BCBS Trust/PPO |
$904.98
|
| Rate for Payer: BCN Commercial |
$2,643.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,771.74
|
| Rate for Payer: Cash Price |
$2,591.20
|
| Rate for Payer: Cash Price |
$2,591.20
|
| Rate for Payer: Cofinity Commercial |
$2,551.31
|
| Rate for Payer: Cofinity Commercial |
$2,374.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,771.74
|
| Rate for Payer: Healthscope Commercial |
$2,126.09
|
| Rate for Payer: Healthscope Whirlpool |
$2,126.09
|
| Rate for Payer: Meridian Medicaid |
$1,209.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,860.33
|
| Rate for Payer: PACE SWMI |
$1,771.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,771.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,151.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,267.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,505.08
|
| Rate for Payer: Priority Health Medicare |
$1,771.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,505.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,824.89
|
|
|
PR MCCD, INITIAL RATE
|
Professional
|
Both
|
$160.00
|
|
|
Service Code
|
HCPCS G9001
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1,218.26 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,218.26
|
| Rate for Payer: BCN Commercial |
$136.23
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.00
|
|
|
PR MCCD,MAINTENANCE RATE
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS G9002
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$884.37 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Complete |
$32.00
|
| Rate for Payer: BCBS Trust/PPO |
$884.37
|
| Rate for Payer: BCN Commercial |
$68.13
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.00
|
|
|
PR MCCD,PHYS COOR-CARE OVRSGHT
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS G9008
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1,823.69 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,823.69
|
| Rate for Payer: BCN Commercial |
$50.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.50
|
|
|
PR MCCD, SCH TEAM CONF
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS G9007
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$1,852.75 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,852.75
|
| Rate for Payer: BCN Commercial |
$28.81
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.00
|
|
|
PR MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 36596
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$745.43 |
| Rate for Payer: Aetna Commercial |
$57.55
|
| Rate for Payer: Aetna Medicare |
$42.95
|
| Rate for Payer: BCBS Complete |
$29.75
|
| Rate for Payer: BCBS MAPPO |
$42.95
|
| Rate for Payer: BCBS Trust/PPO |
$745.43
|
| Rate for Payer: BCN Commercial |
$167.13
|
| Rate for Payer: BCN Medicare Advantage |
$42.95
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$57.55
|
| Rate for Payer: Cofinity Commercial |
$61.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.95
|
| Rate for Payer: Healthscope Commercial |
$51.54
|
| Rate for Payer: Healthscope Whirlpool |
$51.54
|
| Rate for Payer: Meridian Medicaid |
$29.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.10
|
| Rate for Payer: PACE SWMI |
$42.95
|
| Rate for Payer: PHP Medicare Advantage |
$42.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.15
|
| Rate for Payer: Priority Health Medicare |
$42.95
|
| Rate for Payer: Priority Health Narrow Network |
$69.15
|
| Rate for Payer: UHC Medicare Advantage |
$44.24
|
|
|
PR MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS
|
Professional
|
Both
|
$1,120.00
|
|
|
Service Code
|
HCPCS 36595
|
| Min. Negotiated Rate |
$112.68 |
| Max. Negotiated Rate |
$871.31 |
| Rate for Payer: Aetna Commercial |
$236.48
|
| Rate for Payer: Aetna Medicare |
$176.48
|
| Rate for Payer: BCBS Complete |
$118.31
|
| Rate for Payer: BCBS MAPPO |
$176.48
|
| Rate for Payer: BCBS Trust/PPO |
$586.94
|
| Rate for Payer: BCN Commercial |
$871.31
|
| Rate for Payer: BCN Medicare Advantage |
$176.48
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cash Price |
$896.00
|
| Rate for Payer: Cofinity Commercial |
$254.13
|
| Rate for Payer: Cofinity Commercial |
$236.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.48
|
| Rate for Payer: Healthscope Commercial |
$211.78
|
| Rate for Payer: Healthscope Whirlpool |
$211.78
|
| Rate for Payer: Meridian Medicaid |
$118.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$185.30
|
| Rate for Payer: PACE SWMI |
$176.48
|
| Rate for Payer: PHP Medicare Advantage |
$176.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$784.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$281.40
|
| Rate for Payer: Priority Health Medicare |
$176.48
|
| Rate for Payer: Priority Health Narrow Network |
$281.40
|
| Rate for Payer: UHC Medicare Advantage |
$181.77
|
|
|
PR MD CERTIFICATION HHA PATIENT
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS G0180
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$76.60 |
| Rate for Payer: Aetna Commercial |
$67.12
|
| Rate for Payer: Aetna Medicare |
$50.09
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS MAPPO |
$50.09
|
| Rate for Payer: BCBS Trust/PPO |
$76.60
|
| Rate for Payer: BCN Commercial |
$75.75
|
| Rate for Payer: BCN Medicare Advantage |
$50.09
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Cofinity Commercial |
$72.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.09
|
| Rate for Payer: Healthscope Commercial |
$60.11
|
| Rate for Payer: Healthscope Whirlpool |
$60.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$52.59
|
| Rate for Payer: PACE SWMI |
$50.09
|
| Rate for Payer: PHP Medicare Advantage |
$50.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.62
|
| Rate for Payer: Priority Health Medicare |
$50.09
|
| Rate for Payer: Priority Health Narrow Network |
$69.62
|
| Rate for Payer: UHC Medicare Advantage |
$51.59
|
|
|
PR MD RECERTIFICATION HHA PT
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS G0179
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$83.63 |
| Rate for Payer: Aetna Commercial |
$53.00
|
| Rate for Payer: Aetna Medicare |
$39.55
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: BCBS MAPPO |
$39.55
|
| Rate for Payer: BCBS Trust/PPO |
$83.63
|
| Rate for Payer: BCN Commercial |
$60.11
|
| Rate for Payer: BCN Medicare Advantage |
$39.55
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$56.95
|
| Rate for Payer: Cofinity Commercial |
$53.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.55
|
| Rate for Payer: Healthscope Commercial |
$47.46
|
| Rate for Payer: Healthscope Whirlpool |
$47.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.53
|
| Rate for Payer: PACE SWMI |
$39.55
|
| Rate for Payer: PHP Medicare Advantage |
$39.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.24
|
| Rate for Payer: Priority Health Medicare |
$39.55
|
| Rate for Payer: Priority Health Narrow Network |
$55.24
|
| Rate for Payer: UHC Medicare Advantage |
$40.74
|
|
|
PR MD REVIEW INTERPRET OF TEST
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS G0250
|
| Min. Negotiated Rate |
$8.63 |
| Max. Negotiated Rate |
$459.09 |
| Rate for Payer: Aetna Commercial |
$11.56
|
| Rate for Payer: Aetna Medicare |
$8.63
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$8.63
|
| Rate for Payer: BCBS Trust/PPO |
$459.09
|
| Rate for Payer: BCN Commercial |
$12.71
|
| Rate for Payer: BCN Medicare Advantage |
$8.63
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$12.43
|
| Rate for Payer: Cofinity Commercial |
$11.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.63
|
| Rate for Payer: Healthscope Commercial |
$10.36
|
| Rate for Payer: Healthscope Whirlpool |
$10.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.06
|
| Rate for Payer: PACE SWMI |
$8.63
|
| Rate for Payer: PHP Medicare Advantage |
$8.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.14
|
| Rate for Payer: Priority Health Medicare |
$8.63
|
| Rate for Payer: Priority Health Narrow Network |
$11.14
|
| Rate for Payer: UHC Medicare Advantage |
$8.89
|
|
|
PR MD SERVICE REQUIRED FOR PMD
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS G0372
|
| Min. Negotiated Rate |
$8.60 |
| Max. Negotiated Rate |
$1,453.88 |
| Rate for Payer: Aetna Commercial |
$11.52
|
| Rate for Payer: Aetna Medicare |
$8.60
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: BCBS MAPPO |
$8.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,453.88
|
| Rate for Payer: BCN Commercial |
$12.71
|
| Rate for Payer: BCN Medicare Advantage |
$8.60
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$11.52
|
| Rate for Payer: Cofinity Commercial |
$12.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.60
|
| Rate for Payer: Healthscope Commercial |
$10.32
|
| Rate for Payer: Healthscope Whirlpool |
$10.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.03
|
| Rate for Payer: PACE SWMI |
$8.60
|
| Rate for Payer: PHP Medicare Advantage |
$8.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.68
|
| Rate for Payer: Priority Health Medicare |
$8.60
|
| Rate for Payer: Priority Health Narrow Network |
$11.68
|
| Rate for Payer: UHC Medicare Advantage |
$8.86
|
|
|
PR MEASLES MUMPS RUBELLA VARICELLA VACC LIVE SUBQ
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 90710
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$275.04 |
| Rate for Payer: Aetna Commercial |
$275.04
|
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: BCBS Trust/PPO |
$260.00
|
| Rate for Payer: BCN Commercial |
$258.46
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
|
|
PR MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 90707
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$94.50
|
| Rate for Payer: BCBS Complete |
$42.00
|
| Rate for Payer: BCBS Trust/PPO |
$88.32
|
| Rate for Payer: BCN Commercial |
$88.32
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.50
|
|
|
PR MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 51798
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$3,662.70 |
| Rate for Payer: Aetna Commercial |
$13.31
|
| Rate for Payer: Aetna Medicare |
$9.93
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$9.93
|
| Rate for Payer: BCBS Trust/PPO |
$3,662.70
|
| Rate for Payer: BCN Commercial |
$15.64
|
| Rate for Payer: BCN Medicare Advantage |
$9.93
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$14.30
|
| Rate for Payer: Cofinity Commercial |
$13.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.93
|
| Rate for Payer: Healthscope Commercial |
$11.92
|
| Rate for Payer: Healthscope Whirlpool |
$11.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.43
|
| Rate for Payer: PACE SWMI |
$9.93
|
| Rate for Payer: PHP Medicare Advantage |
$9.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.29
|
| Rate for Payer: Priority Health Medicare |
$9.93
|
| Rate for Payer: Priority Health Narrow Network |
$17.29
|
| Rate for Payer: UHC Medicare Advantage |
$10.23
|
|
|
PR MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT
|
Professional
|
Both
|
$335.00
|
|
|
Service Code
|
HCPCS 53020
|
| Min. Negotiated Rate |
$61.13 |
| Max. Negotiated Rate |
$359.24 |
| Rate for Payer: Aetna Commercial |
$126.28
|
| Rate for Payer: Aetna Medicare |
$94.24
|
| Rate for Payer: BCBS Complete |
$64.19
|
| Rate for Payer: BCBS MAPPO |
$94.24
|
| Rate for Payer: BCBS Trust/PPO |
$359.24
|
| Rate for Payer: BCN Commercial |
$138.79
|
| Rate for Payer: BCN Medicare Advantage |
$94.24
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cofinity Commercial |
$126.28
|
| Rate for Payer: Cofinity Commercial |
$135.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.24
|
| Rate for Payer: Healthscope Commercial |
$113.09
|
| Rate for Payer: Healthscope Whirlpool |
$113.09
|
| Rate for Payer: Meridian Medicaid |
$64.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$98.95
|
| Rate for Payer: PACE SWMI |
$94.24
|
| Rate for Payer: PHP Medicare Advantage |
$94.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.46
|
| Rate for Payer: Priority Health Medicare |
$94.24
|
| Rate for Payer: Priority Health Narrow Network |
$153.46
|
| Rate for Payer: UHC Medicare Advantage |
$97.07
|
|
|
PR MEATOTOMY CUTTING MEATUS SPX INFANT
|
Professional
|
Both
|
$350.00
|
|
|
Service Code
|
HCPCS 53025
|
| Min. Negotiated Rate |
$43.67 |
| Max. Negotiated Rate |
$718.49 |
| Rate for Payer: Aetna Commercial |
$89.18
|
| Rate for Payer: Aetna Medicare |
$66.55
|
| Rate for Payer: BCBS Complete |
$45.85
|
| Rate for Payer: BCBS MAPPO |
$66.55
|
| Rate for Payer: BCBS Trust/PPO |
$718.49
|
| Rate for Payer: BCN Commercial |
$98.72
|
| Rate for Payer: BCN Medicare Advantage |
$66.55
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cofinity Commercial |
$95.83
|
| Rate for Payer: Cofinity Commercial |
$89.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.55
|
| Rate for Payer: Healthscope Commercial |
$79.86
|
| Rate for Payer: Healthscope Whirlpool |
$79.86
|
| Rate for Payer: Meridian Medicaid |
$45.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.88
|
| Rate for Payer: PACE SWMI |
$66.55
|
| Rate for Payer: PHP Medicare Advantage |
$66.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$109.15
|
| Rate for Payer: Priority Health Medicare |
$66.55
|
| Rate for Payer: Priority Health Narrow Network |
$109.15
|
| Rate for Payer: UHC Medicare Advantage |
$68.55
|
|
|
PR MEDIASTINOSCOPY INCL BIOPSIES WHEN PERFORMED
|
Professional
|
Both
|
$2,199.00
|
|
|
Service Code
|
HCPCS 39400
|
| Min. Negotiated Rate |
$879.60 |
| Max. Negotiated Rate |
$1,539.30 |
| Rate for Payer: BCBS Complete |
$879.60
|
| Rate for Payer: Cash Price |
$1,759.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,539.30
|
|
|
PR MEDIASTINOSCOPY INCLUDES MEDIASTINAL MASS BIOPSY
|
Professional
|
Both
|
$951.00
|
|
|
Service Code
|
HCPCS 39401
|
| Min. Negotiated Rate |
$194.04 |
| Max. Negotiated Rate |
$665.70 |
| Rate for Payer: Aetna Commercial |
$406.37
|
| Rate for Payer: Aetna Medicare |
$303.26
|
| Rate for Payer: BCBS Complete |
$203.74
|
| Rate for Payer: BCBS MAPPO |
$303.26
|
| Rate for Payer: BCBS Trust/PPO |
$207.62
|
| Rate for Payer: BCN Commercial |
$442.74
|
| Rate for Payer: BCN Medicare Advantage |
$303.26
|
| Rate for Payer: Cash Price |
$760.80
|
| Rate for Payer: Cash Price |
$760.80
|
| Rate for Payer: Cofinity Commercial |
$406.37
|
| Rate for Payer: Cofinity Commercial |
$436.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.26
|
| Rate for Payer: Healthscope Commercial |
$363.91
|
| Rate for Payer: Healthscope Whirlpool |
$363.91
|
| Rate for Payer: Meridian Medicaid |
$203.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$318.42
|
| Rate for Payer: PACE SWMI |
$303.26
|
| Rate for Payer: PHP Medicare Advantage |
$303.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.96
|
| Rate for Payer: Priority Health Medicare |
$303.26
|
| Rate for Payer: Priority Health Narrow Network |
$481.96
|
| Rate for Payer: UHC Medicare Advantage |
$312.36
|
|
|
PR MEDIASTINOSCOPY WITH LYMPH NODE BIOPSY/IES
|
Professional
|
Both
|
$828.00
|
|
|
Service Code
|
HCPCS 39402
|
| Min. Negotiated Rate |
$253.26 |
| Max. Negotiated Rate |
$629.31 |
| Rate for Payer: Aetna Commercial |
$531.56
|
| Rate for Payer: Aetna Medicare |
$396.69
|
| Rate for Payer: BCBS Complete |
$265.92
|
| Rate for Payer: BCBS MAPPO |
$396.69
|
| Rate for Payer: BCBS Trust/PPO |
$487.62
|
| Rate for Payer: BCN Commercial |
$578.11
|
| Rate for Payer: BCN Medicare Advantage |
$396.69
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cofinity Commercial |
$571.23
|
| Rate for Payer: Cofinity Commercial |
$531.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.69
|
| Rate for Payer: Healthscope Commercial |
$476.03
|
| Rate for Payer: Healthscope Whirlpool |
$476.03
|
| Rate for Payer: Meridian Medicaid |
$265.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$416.52
|
| Rate for Payer: PACE SWMI |
$396.69
|
| Rate for Payer: PHP Medicare Advantage |
$396.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$579.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$629.31
|
| Rate for Payer: Priority Health Medicare |
$396.69
|
| Rate for Payer: Priority Health Narrow Network |
$629.31
|
| Rate for Payer: UHC Medicare Advantage |
$408.59
|
|
|
PR MEDIAST W/EXPL DRG RMVL FB/BX CRV APPR
|
Professional
|
Both
|
$2,499.00
|
|
|
Service Code
|
HCPCS 39000
|
| Min. Negotiated Rate |
$322.70 |
| Max. Negotiated Rate |
$1,749.30 |
| Rate for Payer: Aetna Commercial |
$635.15
|
| Rate for Payer: Aetna Medicare |
$473.99
|
| Rate for Payer: BCBS Complete |
$338.84
|
| Rate for Payer: BCBS MAPPO |
$473.99
|
| Rate for Payer: BCBS Trust/PPO |
$418.94
|
| Rate for Payer: BCN Commercial |
$700.27
|
| Rate for Payer: BCN Medicare Advantage |
$473.99
|
| Rate for Payer: Cash Price |
$1,999.20
|
| Rate for Payer: Cash Price |
$1,999.20
|
| Rate for Payer: Cofinity Commercial |
$682.55
|
| Rate for Payer: Cofinity Commercial |
$635.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$473.99
|
| Rate for Payer: Healthscope Commercial |
$568.79
|
| Rate for Payer: Healthscope Whirlpool |
$568.79
|
| Rate for Payer: Meridian Medicaid |
$338.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$497.69
|
| Rate for Payer: PACE SWMI |
$473.99
|
| Rate for Payer: PHP Medicare Advantage |
$473.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$322.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,749.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$762.29
|
| Rate for Payer: Priority Health Medicare |
$473.99
|
| Rate for Payer: Priority Health Narrow Network |
$762.29
|
| Rate for Payer: UHC Medicare Advantage |
$488.21
|
|
|
PR MEDIAST W/EXPL DRG RMVL FB/BX TTHRC APPR
|
Professional
|
Both
|
$5,144.00
|
|
|
Service Code
|
HCPCS 39010
|
| Min. Negotiated Rate |
$499.91 |
| Max. Negotiated Rate |
$3,600.80 |
| Rate for Payer: Aetna Commercial |
$1,039.61
|
| Rate for Payer: Aetna Medicare |
$775.83
|
| Rate for Payer: BCBS Complete |
$524.91
|
| Rate for Payer: BCBS MAPPO |
$775.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,750.26
|
| Rate for Payer: BCN Commercial |
$1,138.13
|
| Rate for Payer: BCN Medicare Advantage |
$775.83
|
| Rate for Payer: Cash Price |
$4,115.20
|
| Rate for Payer: Cash Price |
$4,115.20
|
| Rate for Payer: Cofinity Commercial |
$1,117.20
|
| Rate for Payer: Cofinity Commercial |
$1,039.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$775.83
|
| Rate for Payer: Healthscope Commercial |
$931.00
|
| Rate for Payer: Healthscope Whirlpool |
$931.00
|
| Rate for Payer: Meridian Medicaid |
$524.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$814.62
|
| Rate for Payer: PACE SWMI |
$775.83
|
| Rate for Payer: PHP Medicare Advantage |
$775.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$499.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,600.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,238.92
|
| Rate for Payer: Priority Health Medicare |
$775.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,238.92
|
| Rate for Payer: UHC Medicare Advantage |
$799.10
|
|
|
PR MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI
|
Professional
|
Both
|
$60.00
|
|
|
Service Code
|
HCPCS 97802
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$1,112.07 |
| Rate for Payer: Aetna Commercial |
$41.93
|
| Rate for Payer: Aetna Medicare |
$31.29
|
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: BCBS MAPPO |
$31.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,112.07
|
| Rate for Payer: BCN Commercial |
$53.26
|
| Rate for Payer: BCN Medicare Advantage |
$31.29
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$41.93
|
| Rate for Payer: Cofinity Commercial |
$45.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.29
|
| Rate for Payer: Healthscope Commercial |
$37.55
|
| Rate for Payer: Healthscope Whirlpool |
$37.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.85
|
| Rate for Payer: PACE SWMI |
$31.29
|
| Rate for Payer: PHP Medicare Advantage |
$31.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.34
|
| Rate for Payer: Priority Health Medicare |
$31.29
|
| Rate for Payer: Priority Health Narrow Network |
$33.34
|
| Rate for Payer: UHC Medicare Advantage |
$32.23
|
|
|
PR MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 97803
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$561.58 |
| Rate for Payer: Aetna Commercial |
$35.40
|
| Rate for Payer: Aetna Medicare |
$26.42
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: BCBS MAPPO |
$26.42
|
| Rate for Payer: BCBS Trust/PPO |
$561.58
|
| Rate for Payer: BCN Commercial |
$46.43
|
| Rate for Payer: BCN Medicare Advantage |
$26.42
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$35.40
|
| Rate for Payer: Cofinity Commercial |
$38.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.42
|
| Rate for Payer: Healthscope Commercial |
$31.70
|
| Rate for Payer: Healthscope Whirlpool |
$31.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.74
|
| Rate for Payer: PACE SWMI |
$26.42
|
| Rate for Payer: PHP Medicare Advantage |
$26.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.82
|
| Rate for Payer: Priority Health Medicare |
$26.42
|
| Rate for Payer: Priority Health Narrow Network |
$29.82
|
| Rate for Payer: UHC Medicare Advantage |
$27.21
|
|
|
PR MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 97804
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$641.36 |
| Rate for Payer: Aetna Commercial |
$20.11
|
| Rate for Payer: Aetna Medicare |
$15.01
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS MAPPO |
$15.01
|
| Rate for Payer: BCBS Trust/PPO |
$641.36
|
| Rate for Payer: BCN Commercial |
$24.44
|
| Rate for Payer: BCN Medicare Advantage |
$15.01
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$20.11
|
| Rate for Payer: Cofinity Commercial |
$21.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.01
|
| Rate for Payer: Healthscope Commercial |
$18.01
|
| Rate for Payer: Healthscope Whirlpool |
$18.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.76
|
| Rate for Payer: PACE SWMI |
$15.01
|
| Rate for Payer: PHP Medicare Advantage |
$15.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.57
|
| Rate for Payer: Priority Health Medicare |
$15.01
|
| Rate for Payer: Priority Health Narrow Network |
$15.57
|
| Rate for Payer: UHC Medicare Advantage |
$15.46
|
|
|
PR MEDICATION ADMIN & HEMODYNAMIC MEASURMENT
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 93463
|
| Min. Negotiated Rate |
$60.92 |
| Max. Negotiated Rate |
$735.92 |
| Rate for Payer: Aetna Commercial |
$128.08
|
| Rate for Payer: Aetna Medicare |
$95.58
|
| Rate for Payer: BCBS Complete |
$63.97
|
| Rate for Payer: BCBS MAPPO |
$95.58
|
| Rate for Payer: BCBS Trust/PPO |
$735.92
|
| Rate for Payer: BCN Commercial |
$140.25
|
| Rate for Payer: BCN Medicare Advantage |
$95.58
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$128.08
|
| Rate for Payer: Cofinity Commercial |
$137.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.58
|
| Rate for Payer: Healthscope Commercial |
$114.70
|
| Rate for Payer: Healthscope Whirlpool |
$114.70
|
| Rate for Payer: Meridian Medicaid |
$63.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.36
|
| Rate for Payer: PACE SWMI |
$95.58
|
| Rate for Payer: PHP Medicare Advantage |
$95.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.72
|
| Rate for Payer: Priority Health Medicare |
$95.58
|
| Rate for Payer: Priority Health Narrow Network |
$135.72
|
| Rate for Payer: UHC Medicare Advantage |
$98.45
|
|
