|
PR CRX RPR DURAL/CSF LEAK RHINORRHEA/OTORRHEA
|
Professional
|
Both
|
$7,464.00
|
|
|
Service Code
|
HCPCS 62100
|
| Min. Negotiated Rate |
$928.68 |
| Max. Negotiated Rate |
$5,598.00 |
| Rate for Payer: Aetna Commercial |
$1,942.80
|
| Rate for Payer: Aetna Medicare |
$1,449.85
|
| Rate for Payer: BCBS Complete |
$975.11
|
| Rate for Payer: BCBS MAPPO |
$1,449.85
|
| Rate for Payer: BCN Commercial |
$3,294.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,449.85
|
| Rate for Payer: Cash Price |
$5,971.20
|
| Rate for Payer: Cash Price |
$5,971.20
|
| Rate for Payer: Cofinity Commercial |
$2,087.78
|
| Rate for Payer: Cofinity Commercial |
$1,942.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,449.85
|
| Rate for Payer: Healthscope Commercial |
$1,739.82
|
| Rate for Payer: Healthscope Whirlpool |
$1,739.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,522.34
|
| Rate for Payer: Meridian Medicaid |
$975.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,594.84
|
| Rate for Payer: Nomi Health Commercial |
$1,739.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,598.00
|
| Rate for Payer: PACE SWMI |
$1,449.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,449.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$928.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,769.36
|
| Rate for Payer: Priority Health Medicare |
$1,449.85
|
| Rate for Payer: Priority Health Narrow Network |
$2,769.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,449.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,785.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,449.85
|
| Rate for Payer: UHC Exchange |
$2,785.91
|
| Rate for Payer: UHC Medicaid |
$928.68
|
| Rate for Payer: UHCCP DNSP |
$1,449.85
|
| Rate for Payer: UHCCP Medicaid |
$928.68
|
|
|
PR CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI
|
Professional
|
Both
|
$2,130.00
|
|
|
Service Code
|
HCPCS 55873
|
| Min. Negotiated Rate |
$438.99 |
| Max. Negotiated Rate |
$1,597.50 |
| Rate for Payer: Aetna Commercial |
$910.17
|
| Rate for Payer: Aetna Medicare |
$679.23
|
| Rate for Payer: BCBS Complete |
$460.94
|
| Rate for Payer: BCBS MAPPO |
$679.23
|
| Rate for Payer: BCN Commercial |
$1,145.85
|
| Rate for Payer: BCN Medicare Advantage |
$679.23
|
| Rate for Payer: Cash Price |
$1,704.00
|
| Rate for Payer: Cash Price |
$1,704.00
|
| Rate for Payer: Cofinity Commercial |
$978.09
|
| Rate for Payer: Cofinity Commercial |
$910.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$679.23
|
| Rate for Payer: Healthscope Commercial |
$815.08
|
| Rate for Payer: Healthscope Whirlpool |
$815.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$713.19
|
| Rate for Payer: Meridian Medicaid |
$460.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$747.15
|
| Rate for Payer: Nomi Health Commercial |
$815.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,597.50
|
| Rate for Payer: PACE SWMI |
$679.23
|
| Rate for Payer: PHP Medicare Advantage |
$679.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$438.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,248.20
|
| Rate for Payer: Priority Health Medicare |
$679.23
|
| Rate for Payer: Priority Health Narrow Network |
$1,248.20
|
| Rate for Payer: Railroad Medicare Medicare |
$679.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,348.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$679.23
|
| Rate for Payer: UHC Exchange |
$1,348.34
|
| Rate for Payer: UHC Medicaid |
$438.99
|
| Rate for Payer: UHCCP DNSP |
$679.23
|
| Rate for Payer: UHCCP Medicaid |
$438.99
|
|
|
PR CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 17340
|
| Min. Negotiated Rate |
$26.84 |
| Max. Negotiated Rate |
$85.61 |
| Rate for Payer: Aetna Commercial |
$55.09
|
| Rate for Payer: Aetna Medicare |
$41.11
|
| Rate for Payer: BCBS Complete |
$28.18
|
| Rate for Payer: BCBS MAPPO |
$41.11
|
| Rate for Payer: BCN Commercial |
$73.70
|
| Rate for Payer: BCN Medicare Advantage |
$41.11
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$59.20
|
| Rate for Payer: Cofinity Commercial |
$55.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.11
|
| Rate for Payer: Healthscope Commercial |
$49.33
|
| Rate for Payer: Healthscope Whirlpool |
$49.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.17
|
| Rate for Payer: Meridian Medicaid |
$28.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.22
|
| Rate for Payer: Nomi Health Commercial |
$49.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.50
|
| Rate for Payer: PACE SWMI |
$41.11
|
| Rate for Payer: PHP Medicare Advantage |
$41.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$67.45
|
| Rate for Payer: Priority Health Medicare |
$41.11
|
| Rate for Payer: Priority Health Narrow Network |
$67.45
|
| Rate for Payer: Railroad Medicare Medicare |
$41.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.11
|
| Rate for Payer: UHC Exchange |
$85.61
|
| Rate for Payer: UHC Medicaid |
$26.84
|
| Rate for Payer: UHCCP DNSP |
$41.11
|
| Rate for Payer: UHCCP Medicaid |
$26.84
|
|
|
PR CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC
|
Professional
|
Both
|
$4,697.00
|
|
|
Service Code
|
HCPCS 51595
|
| Min. Negotiated Rate |
$1,233.91 |
| Max. Negotiated Rate |
$3,877.80 |
| Rate for Payer: Aetna Commercial |
$2,575.24
|
| Rate for Payer: Aetna Medicare |
$1,921.82
|
| Rate for Payer: BCBS Complete |
$1,295.61
|
| Rate for Payer: BCBS MAPPO |
$1,921.82
|
| Rate for Payer: BCN Commercial |
$3,242.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,921.82
|
| Rate for Payer: Cash Price |
$3,757.60
|
| Rate for Payer: Cash Price |
$3,757.60
|
| Rate for Payer: Cofinity Commercial |
$2,767.42
|
| Rate for Payer: Cofinity Commercial |
$2,575.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,921.82
|
| Rate for Payer: Healthscope Commercial |
$2,306.18
|
| Rate for Payer: Healthscope Whirlpool |
$2,306.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,017.91
|
| Rate for Payer: Meridian Medicaid |
$1,295.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,114.00
|
| Rate for Payer: Nomi Health Commercial |
$2,306.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,522.75
|
| Rate for Payer: PACE SWMI |
$1,921.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,921.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,233.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,532.51
|
| Rate for Payer: Priority Health Medicare |
$1,921.82
|
| Rate for Payer: Priority Health Narrow Network |
$3,532.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,921.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,877.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,921.82
|
| Rate for Payer: UHC Exchange |
$3,877.80
|
| Rate for Payer: UHC Medicaid |
$1,233.91
|
| Rate for Payer: UHCCP DNSP |
$1,921.82
|
| Rate for Payer: UHCCP Medicaid |
$1,233.91
|
|
|
PR CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR
|
Professional
|
Both
|
$5,053.00
|
|
|
Service Code
|
HCPCS 51596
|
| Min. Negotiated Rate |
$1,331.68 |
| Max. Negotiated Rate |
$4,169.37 |
| Rate for Payer: Aetna Commercial |
$2,777.81
|
| Rate for Payer: Aetna Medicare |
$2,072.99
|
| Rate for Payer: BCBS Complete |
$1,398.26
|
| Rate for Payer: BCBS MAPPO |
$2,072.99
|
| Rate for Payer: BCN Commercial |
$3,503.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,072.99
|
| Rate for Payer: Cash Price |
$4,042.40
|
| Rate for Payer: Cash Price |
$4,042.40
|
| Rate for Payer: Cofinity Commercial |
$2,985.11
|
| Rate for Payer: Cofinity Commercial |
$2,777.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,072.99
|
| Rate for Payer: Healthscope Commercial |
$2,487.59
|
| Rate for Payer: Healthscope Whirlpool |
$2,487.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,176.64
|
| Rate for Payer: Meridian Medicaid |
$1,398.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,280.29
|
| Rate for Payer: Nomi Health Commercial |
$2,487.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,789.75
|
| Rate for Payer: PACE SWMI |
$2,072.99
|
| Rate for Payer: PHP Medicare Advantage |
$2,072.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,331.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,816.23
|
| Rate for Payer: Priority Health Medicare |
$2,072.99
|
| Rate for Payer: Priority Health Narrow Network |
$3,816.23
|
| Rate for Payer: Railroad Medicare Medicare |
$2,072.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4,169.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,072.99
|
| Rate for Payer: UHC Exchange |
$4,169.37
|
| Rate for Payer: UHC Medicaid |
$1,331.68
|
| Rate for Payer: UHCCP DNSP |
$2,072.99
|
| Rate for Payer: UHCCP Medicaid |
$1,331.68
|
|
|
PR CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST
|
Professional
|
Both
|
$5,058.00
|
|
|
Service Code
|
HCPCS 51590
|
| Min. Negotiated Rate |
$1,091.63 |
| Max. Negotiated Rate |
$3,793.50 |
| Rate for Payer: Aetna Commercial |
$2,277.71
|
| Rate for Payer: Aetna Medicare |
$1,699.78
|
| Rate for Payer: BCBS Complete |
$1,146.21
|
| Rate for Payer: BCBS MAPPO |
$1,699.78
|
| Rate for Payer: BCN Commercial |
$2,866.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,699.78
|
| Rate for Payer: Cash Price |
$4,046.40
|
| Rate for Payer: Cash Price |
$4,046.40
|
| Rate for Payer: Cofinity Commercial |
$2,447.68
|
| Rate for Payer: Cofinity Commercial |
$2,277.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,699.78
|
| Rate for Payer: Healthscope Commercial |
$2,039.74
|
| Rate for Payer: Healthscope Whirlpool |
$2,039.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,784.77
|
| Rate for Payer: Meridian Medicaid |
$1,146.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,869.76
|
| Rate for Payer: Nomi Health Commercial |
$2,039.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,793.50
|
| Rate for Payer: PACE SWMI |
$1,699.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,699.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,091.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,122.96
|
| Rate for Payer: Priority Health Medicare |
$1,699.78
|
| Rate for Payer: Priority Health Narrow Network |
$3,122.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,699.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,428.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,699.78
|
| Rate for Payer: UHC Exchange |
$3,428.10
|
| Rate for Payer: UHC Medicaid |
$1,091.63
|
| Rate for Payer: UHCCP DNSP |
$1,699.78
|
| Rate for Payer: UHCCP Medicaid |
$1,091.63
|
|
|
PR CSTC PRTL W/RIMPLTJ URTR IN BLDR URTRONEOCSTOST
|
Professional
|
Both
|
$2,732.00
|
|
|
Service Code
|
HCPCS 51565
|
| Min. Negotiated Rate |
$734.00 |
| Max. Negotiated Rate |
$2,301.86 |
| Rate for Payer: Aetna Commercial |
$1,526.77
|
| Rate for Payer: Aetna Medicare |
$1,139.38
|
| Rate for Payer: BCBS Complete |
$770.70
|
| Rate for Payer: BCBS MAPPO |
$1,139.38
|
| Rate for Payer: BCN Commercial |
$1,919.22
|
| Rate for Payer: BCN Medicare Advantage |
$1,139.38
|
| Rate for Payer: Cash Price |
$2,185.60
|
| Rate for Payer: Cash Price |
$2,185.60
|
| Rate for Payer: Cofinity Commercial |
$1,640.71
|
| Rate for Payer: Cofinity Commercial |
$1,526.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,139.38
|
| Rate for Payer: Healthscope Commercial |
$1,367.26
|
| Rate for Payer: Healthscope Whirlpool |
$1,367.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,196.35
|
| Rate for Payer: Meridian Medicaid |
$770.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,253.32
|
| Rate for Payer: Nomi Health Commercial |
$1,367.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,049.00
|
| Rate for Payer: PACE SWMI |
$1,139.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,139.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$734.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,090.65
|
| Rate for Payer: Priority Health Medicare |
$1,139.38
|
| Rate for Payer: Priority Health Narrow Network |
$2,090.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,139.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,301.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,139.38
|
| Rate for Payer: UHC Exchange |
$2,301.86
|
| Rate for Payer: UHC Medicaid |
$734.00
|
| Rate for Payer: UHCCP DNSP |
$1,139.38
|
| Rate for Payer: UHCCP Medicaid |
$734.00
|
|
|
PR CSTOPLASTY/CSTOURTP PLSTC ANY
|
Professional
|
Both
|
$1,169.00
|
|
|
Service Code
|
HCPCS 51800
|
| Min. Negotiated Rate |
$593.84 |
| Max. Negotiated Rate |
$1,843.34 |
| Rate for Payer: Aetna Commercial |
$1,233.91
|
| Rate for Payer: Aetna Medicare |
$920.83
|
| Rate for Payer: BCBS Complete |
$623.53
|
| Rate for Payer: BCBS MAPPO |
$920.83
|
| Rate for Payer: BCN Commercial |
$1,548.72
|
| Rate for Payer: BCN Medicare Advantage |
$920.83
|
| Rate for Payer: Cash Price |
$935.20
|
| Rate for Payer: Cash Price |
$935.20
|
| Rate for Payer: Cofinity Commercial |
$1,326.00
|
| Rate for Payer: Cofinity Commercial |
$1,233.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$920.83
|
| Rate for Payer: Healthscope Commercial |
$1,105.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,105.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$966.87
|
| Rate for Payer: Meridian Medicaid |
$623.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,012.91
|
| Rate for Payer: Nomi Health Commercial |
$1,105.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$876.75
|
| Rate for Payer: PACE SWMI |
$920.83
|
| Rate for Payer: PHP Medicare Advantage |
$920.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$593.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,687.07
|
| Rate for Payer: Priority Health Medicare |
$920.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,687.07
|
| Rate for Payer: Railroad Medicare Medicare |
$920.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,843.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$920.83
|
| Rate for Payer: UHC Exchange |
$1,843.34
|
| Rate for Payer: UHC Medicaid |
$593.84
|
| Rate for Payer: UHCCP DNSP |
$920.83
|
| Rate for Payer: UHCCP Medicaid |
$593.84
|
|
|
PR CSTOURTP W/UNI/BI URTRONEOCSTOST
|
Professional
|
Both
|
$2,490.00
|
|
|
Service Code
|
HCPCS 51820
|
| Min. Negotiated Rate |
$621.75 |
| Max. Negotiated Rate |
$1,914.77 |
| Rate for Payer: Aetna Commercial |
$1,291.05
|
| Rate for Payer: Aetna Medicare |
$963.47
|
| Rate for Payer: BCBS Complete |
$652.84
|
| Rate for Payer: BCBS MAPPO |
$963.47
|
| Rate for Payer: BCN Commercial |
$1,619.93
|
| Rate for Payer: BCN Medicare Advantage |
$963.47
|
| Rate for Payer: Cash Price |
$1,992.00
|
| Rate for Payer: Cash Price |
$1,992.00
|
| Rate for Payer: Cofinity Commercial |
$1,387.40
|
| Rate for Payer: Cofinity Commercial |
$1,291.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$963.47
|
| Rate for Payer: Healthscope Commercial |
$1,156.16
|
| Rate for Payer: Healthscope Whirlpool |
$1,156.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,011.64
|
| Rate for Payer: Meridian Medicaid |
$652.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,059.82
|
| Rate for Payer: Nomi Health Commercial |
$1,156.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,867.50
|
| Rate for Payer: PACE SWMI |
$963.47
|
| Rate for Payer: PHP Medicare Advantage |
$963.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$621.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,764.63
|
| Rate for Payer: Priority Health Medicare |
$963.47
|
| Rate for Payer: Priority Health Narrow Network |
$1,764.63
|
| Rate for Payer: Railroad Medicare Medicare |
$963.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,914.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$963.47
|
| Rate for Payer: UHC Exchange |
$1,914.77
|
| Rate for Payer: UHC Medicaid |
$621.75
|
| Rate for Payer: UHCCP DNSP |
$963.47
|
| Rate for Payer: UHCCP Medicaid |
$621.75
|
|
|
PR CTRL NASOPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ
|
Professional
|
Both
|
$965.00
|
|
|
Service Code
|
HCPCS 42972
|
| Min. Negotiated Rate |
$283.50 |
| Max. Negotiated Rate |
$931.98 |
| Rate for Payer: Aetna Commercial |
$583.14
|
| Rate for Payer: Aetna Medicare |
$435.18
|
| Rate for Payer: BCBS Complete |
$297.68
|
| Rate for Payer: BCBS MAPPO |
$435.18
|
| Rate for Payer: BCN Commercial |
$764.90
|
| Rate for Payer: BCN Medicare Advantage |
$435.18
|
| Rate for Payer: Cash Price |
$772.00
|
| Rate for Payer: Cash Price |
$772.00
|
| Rate for Payer: Cofinity Commercial |
$626.66
|
| Rate for Payer: Cofinity Commercial |
$583.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$435.18
|
| Rate for Payer: Healthscope Commercial |
$522.22
|
| Rate for Payer: Healthscope Whirlpool |
$522.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$456.94
|
| Rate for Payer: Meridian Medicaid |
$297.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$478.70
|
| Rate for Payer: Nomi Health Commercial |
$522.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$723.75
|
| Rate for Payer: PACE SWMI |
$435.18
|
| Rate for Payer: PHP Medicare Advantage |
$435.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$931.98
|
| Rate for Payer: Priority Health Medicare |
$435.18
|
| Rate for Payer: Priority Health Narrow Network |
$931.98
|
| Rate for Payer: Railroad Medicare Medicare |
$435.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$879.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$435.18
|
| Rate for Payer: UHC Exchange |
$879.71
|
| Rate for Payer: UHC Medicaid |
$283.50
|
| Rate for Payer: UHCCP DNSP |
$435.18
|
| Rate for Payer: UHCCP Medicaid |
$283.50
|
|
|
PR CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS
|
Professional
|
Both
|
$771.00
|
|
|
Service Code
|
HCPCS 42970
|
| Min. Negotiated Rate |
$232.38 |
| Max. Negotiated Rate |
$757.23 |
| Rate for Payer: Aetna Commercial |
$475.93
|
| Rate for Payer: Aetna Medicare |
$355.17
|
| Rate for Payer: BCBS Complete |
$244.00
|
| Rate for Payer: BCBS MAPPO |
$355.17
|
| Rate for Payer: BCN Commercial |
$621.48
|
| Rate for Payer: BCN Medicare Advantage |
$355.17
|
| Rate for Payer: Cash Price |
$616.80
|
| Rate for Payer: Cash Price |
$616.80
|
| Rate for Payer: Cofinity Commercial |
$511.44
|
| Rate for Payer: Cofinity Commercial |
$475.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.17
|
| Rate for Payer: Healthscope Commercial |
$426.20
|
| Rate for Payer: Healthscope Whirlpool |
$426.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$372.93
|
| Rate for Payer: Meridian Medicaid |
$244.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$390.69
|
| Rate for Payer: Nomi Health Commercial |
$426.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$578.25
|
| Rate for Payer: PACE SWMI |
$355.17
|
| Rate for Payer: PHP Medicare Advantage |
$355.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$757.23
|
| Rate for Payer: Priority Health Medicare |
$355.17
|
| Rate for Payer: Priority Health Narrow Network |
$757.23
|
| Rate for Payer: Railroad Medicare Medicare |
$355.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$709.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$355.17
|
| Rate for Payer: UHC Exchange |
$709.22
|
| Rate for Payer: UHC Medicaid |
$232.38
|
| Rate for Payer: UHCCP DNSP |
$355.17
|
| Rate for Payer: UHCCP Medicaid |
$232.38
|
|
|
PR CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST
|
Professional
|
Both
|
$592.00
|
|
|
Service Code
|
HCPCS 30905
|
| Min. Negotiated Rate |
$63.26 |
| Max. Negotiated Rate |
$444.00 |
| Rate for Payer: Aetna Commercial |
$132.61
|
| Rate for Payer: Aetna Medicare |
$98.96
|
| Rate for Payer: BCBS Complete |
$66.42
|
| Rate for Payer: BCBS MAPPO |
$98.96
|
| Rate for Payer: BCN Commercial |
$158.86
|
| Rate for Payer: BCN Medicare Advantage |
$98.96
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cash Price |
$473.60
|
| Rate for Payer: Cofinity Commercial |
$142.50
|
| Rate for Payer: Cofinity Commercial |
$132.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.96
|
| Rate for Payer: Healthscope Commercial |
$118.75
|
| Rate for Payer: Healthscope Whirlpool |
$118.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.91
|
| Rate for Payer: Meridian Medicaid |
$66.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.86
|
| Rate for Payer: Nomi Health Commercial |
$118.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$444.00
|
| Rate for Payer: PACE SWMI |
$98.96
|
| Rate for Payer: PHP Medicare Advantage |
$98.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$149.60
|
| Rate for Payer: Priority Health Medicare |
$98.96
|
| Rate for Payer: Priority Health Narrow Network |
$149.60
|
| Rate for Payer: Railroad Medicare Medicare |
$98.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$188.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.96
|
| Rate for Payer: UHC Exchange |
$188.70
|
| Rate for Payer: UHC Medicaid |
$63.26
|
| Rate for Payer: UHCCP DNSP |
$98.96
|
| Rate for Payer: UHCCP Medicaid |
$63.26
|
|
|
PR CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ
|
Professional
|
Both
|
$617.00
|
|
|
Service Code
|
HCPCS 30906
|
| Min. Negotiated Rate |
$76.04 |
| Max. Negotiated Rate |
$462.75 |
| Rate for Payer: Aetna Commercial |
$159.34
|
| Rate for Payer: Aetna Medicare |
$118.91
|
| Rate for Payer: BCBS Complete |
$79.84
|
| Rate for Payer: BCBS MAPPO |
$118.91
|
| Rate for Payer: BCN Commercial |
$197.20
|
| Rate for Payer: BCN Medicare Advantage |
$118.91
|
| Rate for Payer: Cash Price |
$493.60
|
| Rate for Payer: Cash Price |
$493.60
|
| Rate for Payer: Cofinity Commercial |
$171.23
|
| Rate for Payer: Cofinity Commercial |
$159.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.91
|
| Rate for Payer: Healthscope Commercial |
$142.69
|
| Rate for Payer: Healthscope Whirlpool |
$142.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.86
|
| Rate for Payer: Meridian Medicaid |
$79.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.80
|
| Rate for Payer: Nomi Health Commercial |
$142.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$462.75
|
| Rate for Payer: PACE SWMI |
$118.91
|
| Rate for Payer: PHP Medicare Advantage |
$118.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$185.70
|
| Rate for Payer: Priority Health Medicare |
$118.91
|
| Rate for Payer: Priority Health Narrow Network |
$185.70
|
| Rate for Payer: Railroad Medicare Medicare |
$118.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$240.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.91
|
| Rate for Payer: UHC Exchange |
$240.26
|
| Rate for Payer: UHC Medicaid |
$76.04
|
| Rate for Payer: UHCCP DNSP |
$118.91
|
| Rate for Payer: UHCCP Medicaid |
$76.04
|
|
|
PR CTRL OROPHARYNGEAL HEMORRHAGE COMP REQ HOSPITJ
|
Professional
|
Both
|
$803.00
|
|
|
Service Code
|
HCPCS 42961
|
| Min. Negotiated Rate |
$237.71 |
| Max. Negotiated Rate |
$772.40 |
| Rate for Payer: Aetna Commercial |
$485.88
|
| Rate for Payer: Aetna Medicare |
$362.60
|
| Rate for Payer: BCBS Complete |
$249.60
|
| Rate for Payer: BCBS MAPPO |
$362.60
|
| Rate for Payer: BCN Commercial |
$633.93
|
| Rate for Payer: BCN Medicare Advantage |
$362.60
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cofinity Commercial |
$522.14
|
| Rate for Payer: Cofinity Commercial |
$485.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.60
|
| Rate for Payer: Healthscope Commercial |
$435.12
|
| Rate for Payer: Healthscope Whirlpool |
$435.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.73
|
| Rate for Payer: Meridian Medicaid |
$249.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$398.86
|
| Rate for Payer: Nomi Health Commercial |
$435.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$602.25
|
| Rate for Payer: PACE SWMI |
$362.60
|
| Rate for Payer: PHP Medicare Advantage |
$362.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$772.40
|
| Rate for Payer: Priority Health Medicare |
$362.60
|
| Rate for Payer: Priority Health Narrow Network |
$772.40
|
| Rate for Payer: Railroad Medicare Medicare |
$362.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$719.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$362.60
|
| Rate for Payer: UHC Exchange |
$719.87
|
| Rate for Payer: UHC Medicaid |
$237.71
|
| Rate for Payer: UHCCP DNSP |
$362.60
|
| Rate for Payer: UHCCP Medicaid |
$237.71
|
|
|
PR CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ
|
Professional
|
Both
|
$1,958.00
|
|
|
Service Code
|
HCPCS 42962
|
| Min. Negotiated Rate |
$292.02 |
| Max. Negotiated Rate |
$1,468.50 |
| Rate for Payer: Aetna Commercial |
$598.59
|
| Rate for Payer: Aetna Medicare |
$446.71
|
| Rate for Payer: BCBS Complete |
$306.62
|
| Rate for Payer: BCBS MAPPO |
$446.71
|
| Rate for Payer: BCN Commercial |
$781.33
|
| Rate for Payer: BCN Medicare Advantage |
$446.71
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cash Price |
$1,566.40
|
| Rate for Payer: Cofinity Commercial |
$643.26
|
| Rate for Payer: Cofinity Commercial |
$598.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$446.71
|
| Rate for Payer: Healthscope Commercial |
$536.05
|
| Rate for Payer: Healthscope Whirlpool |
$536.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$469.05
|
| Rate for Payer: Meridian Medicaid |
$306.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$491.38
|
| Rate for Payer: Nomi Health Commercial |
$536.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,468.50
|
| Rate for Payer: PACE SWMI |
$446.71
|
| Rate for Payer: PHP Medicare Advantage |
$446.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$292.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$952.01
|
| Rate for Payer: Priority Health Medicare |
$446.71
|
| Rate for Payer: Priority Health Narrow Network |
$952.01
|
| Rate for Payer: Railroad Medicare Medicare |
$446.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$889.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$446.71
|
| Rate for Payer: UHC Exchange |
$889.35
|
| Rate for Payer: UHC Medicaid |
$292.02
|
| Rate for Payer: UHCCP DNSP |
$446.71
|
| Rate for Payer: UHCCP Medicaid |
$292.02
|
|
|
PR CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS
|
Professional
|
Both
|
$555.00
|
|
|
Service Code
|
HCPCS 95929
|
| Min. Negotiated Rate |
$233.30 |
| Max. Negotiated Rate |
$416.25 |
| Rate for Payer: Aetna Commercial |
$312.62
|
| Rate for Payer: Aetna Medicare |
$233.30
|
| Rate for Payer: BCBS MAPPO |
$233.30
|
| Rate for Payer: BCN Commercial |
$353.07
|
| Rate for Payer: BCN Medicare Advantage |
$233.30
|
| Rate for Payer: Cash Price |
$444.00
|
| Rate for Payer: Cash Price |
$444.00
|
| Rate for Payer: Cofinity Commercial |
$312.62
|
| Rate for Payer: Cofinity Commercial |
$335.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.30
|
| Rate for Payer: Healthscope Commercial |
$279.96
|
| Rate for Payer: Healthscope Whirlpool |
$279.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$244.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$256.63
|
| Rate for Payer: Nomi Health Commercial |
$279.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$416.25
|
| Rate for Payer: PACE SWMI |
$233.30
|
| Rate for Payer: PHP Medicare Advantage |
$233.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$325.61
|
| Rate for Payer: Priority Health Medicare |
$233.30
|
| Rate for Payer: Priority Health Narrow Network |
$325.61
|
| Rate for Payer: Railroad Medicare Medicare |
$233.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$357.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$233.30
|
| Rate for Payer: UHC Exchange |
$357.05
|
| Rate for Payer: UHCCP DNSP |
$233.30
|
|
|
PR CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS
|
Professional
|
Both
|
$512.00
|
|
|
Service Code
|
HCPCS 95928
|
| Min. Negotiated Rate |
$238.79 |
| Max. Negotiated Rate |
$384.00 |
| Rate for Payer: Aetna Commercial |
$319.98
|
| Rate for Payer: Aetna Commercial |
$319.98
|
| Rate for Payer: Aetna Medicare |
$238.79
|
| Rate for Payer: Aetna Medicare |
$238.79
|
| Rate for Payer: BCBS MAPPO |
$238.79
|
| Rate for Payer: BCBS MAPPO |
$238.79
|
| Rate for Payer: BCN Commercial |
$352.57
|
| Rate for Payer: BCN Commercial |
$352.57
|
| Rate for Payer: BCN Medicare Advantage |
$238.79
|
| Rate for Payer: BCN Medicare Advantage |
$238.79
|
| Rate for Payer: Cash Price |
$409.60
|
| Rate for Payer: Cash Price |
$409.60
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cofinity Commercial |
$343.86
|
| Rate for Payer: Cofinity Commercial |
$319.98
|
| Rate for Payer: Cofinity Commercial |
$343.86
|
| Rate for Payer: Cofinity Commercial |
$319.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$238.79
|
| Rate for Payer: Healthscope Commercial |
$286.55
|
| Rate for Payer: Healthscope Commercial |
$286.55
|
| Rate for Payer: Healthscope Whirlpool |
$286.55
|
| Rate for Payer: Healthscope Whirlpool |
$286.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$262.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$262.67
|
| Rate for Payer: Nomi Health Commercial |
$286.55
|
| Rate for Payer: Nomi Health Commercial |
$286.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$262.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$384.00
|
| Rate for Payer: PACE SWMI |
$238.79
|
| Rate for Payer: PACE SWMI |
$238.79
|
| Rate for Payer: PHP Medicare Advantage |
$238.79
|
| Rate for Payer: PHP Medicare Advantage |
$238.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$325.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$325.14
|
| Rate for Payer: Priority Health Medicare |
$238.79
|
| Rate for Payer: Priority Health Medicare |
$238.79
|
| Rate for Payer: Priority Health Narrow Network |
$325.14
|
| Rate for Payer: Priority Health Narrow Network |
$325.14
|
| Rate for Payer: Railroad Medicare Medicare |
$238.79
|
| Rate for Payer: Railroad Medicare Medicare |
$238.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$346.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$346.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$238.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$238.79
|
| Rate for Payer: UHC Exchange |
$346.94
|
| Rate for Payer: UHC Exchange |
$346.94
|
| Rate for Payer: UHCCP DNSP |
$238.79
|
| Rate for Payer: UHCCP DNSP |
$238.79
|
|
|
PR CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LI
|
Professional
|
Both
|
$338.00
|
|
|
Service Code
|
HCPCS 95939
|
| Min. Negotiated Rate |
$253.50 |
| Max. Negotiated Rate |
$823.66 |
| Rate for Payer: Aetna Commercial |
$730.81
|
| Rate for Payer: Aetna Medicare |
$545.38
|
| Rate for Payer: BCBS MAPPO |
$545.38
|
| Rate for Payer: BCN Commercial |
$823.66
|
| Rate for Payer: BCN Medicare Advantage |
$545.38
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cash Price |
$270.40
|
| Rate for Payer: Cofinity Commercial |
$730.81
|
| Rate for Payer: Cofinity Commercial |
$785.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$545.38
|
| Rate for Payer: Healthscope Commercial |
$654.46
|
| Rate for Payer: Healthscope Whirlpool |
$654.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$572.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$599.92
|
| Rate for Payer: Nomi Health Commercial |
$654.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.50
|
| Rate for Payer: PACE SWMI |
$545.38
|
| Rate for Payer: PHP Medicare Advantage |
$545.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$759.59
|
| Rate for Payer: Priority Health Medicare |
$545.38
|
| Rate for Payer: Priority Health Narrow Network |
$759.59
|
| Rate for Payer: Railroad Medicare Medicare |
$545.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$800.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$545.38
|
| Rate for Payer: UHC Exchange |
$800.77
|
| Rate for Payer: UHCCP DNSP |
$545.38
|
|
|
PR CURETTAGE POSTPARTUM
|
Professional
|
Both
|
$562.00
|
|
|
Service Code
|
HCPCS 59160
|
| Min. Negotiated Rate |
$106.93 |
| Max. Negotiated Rate |
$421.50 |
| Rate for Payer: Aetna Commercial |
$224.02
|
| Rate for Payer: Aetna Medicare |
$167.18
|
| Rate for Payer: BCBS Complete |
$112.28
|
| Rate for Payer: BCBS MAPPO |
$167.18
|
| Rate for Payer: BCN Commercial |
$282.35
|
| Rate for Payer: BCN Medicare Advantage |
$167.18
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cash Price |
$449.60
|
| Rate for Payer: Cofinity Commercial |
$240.74
|
| Rate for Payer: Cofinity Commercial |
$224.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.18
|
| Rate for Payer: Healthscope Commercial |
$200.62
|
| Rate for Payer: Healthscope Whirlpool |
$200.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.54
|
| Rate for Payer: Meridian Medicaid |
$112.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$183.90
|
| Rate for Payer: Nomi Health Commercial |
$200.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$421.50
|
| Rate for Payer: PACE SWMI |
$167.18
|
| Rate for Payer: PHP Medicare Advantage |
$167.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$266.54
|
| Rate for Payer: Priority Health Medicare |
$167.18
|
| Rate for Payer: Priority Health Narrow Network |
$266.54
|
| Rate for Payer: Railroad Medicare Medicare |
$167.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$167.18
|
| Rate for Payer: UHC Exchange |
$322.60
|
| Rate for Payer: UHC Medicaid |
$106.93
|
| Rate for Payer: UHCCP DNSP |
$167.18
|
| Rate for Payer: UHCCP Medicaid |
$106.93
|
|
|
PR CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST
|
Professional
|
Both
|
$493.00
|
|
|
Service Code
|
HCPCS 46940
|
| Min. Negotiated Rate |
$87.12 |
| Max. Negotiated Rate |
$369.75 |
| Rate for Payer: Aetna Commercial |
$179.43
|
| Rate for Payer: Aetna Medicare |
$133.90
|
| Rate for Payer: BCBS Complete |
$91.48
|
| Rate for Payer: BCBS MAPPO |
$133.90
|
| Rate for Payer: BCN Commercial |
$218.12
|
| Rate for Payer: BCN Medicare Advantage |
$133.90
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cofinity Commercial |
$192.82
|
| Rate for Payer: Cofinity Commercial |
$179.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.90
|
| Rate for Payer: Healthscope Commercial |
$160.68
|
| Rate for Payer: Healthscope Whirlpool |
$160.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.59
|
| Rate for Payer: Meridian Medicaid |
$91.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.29
|
| Rate for Payer: Nomi Health Commercial |
$160.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$369.75
|
| Rate for Payer: PACE SWMI |
$133.90
|
| Rate for Payer: PHP Medicare Advantage |
$133.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$265.76
|
| Rate for Payer: Priority Health Medicare |
$133.90
|
| Rate for Payer: Priority Health Narrow Network |
$265.76
|
| Rate for Payer: Railroad Medicare Medicare |
$133.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$253.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.90
|
| Rate for Payer: UHC Exchange |
$253.26
|
| Rate for Payer: UHC Medicaid |
$87.12
|
| Rate for Payer: UHCCP DNSP |
$133.90
|
| Rate for Payer: UHCCP Medicaid |
$87.12
|
|
|
PR CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ
|
Professional
|
Both
|
$345.00
|
|
|
Service Code
|
HCPCS 46942
|
| Min. Negotiated Rate |
$78.81 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Aetna Commercial |
$161.86
|
| Rate for Payer: Aetna Medicare |
$120.79
|
| Rate for Payer: BCBS Complete |
$82.75
|
| Rate for Payer: BCBS MAPPO |
$120.79
|
| Rate for Payer: BCN Commercial |
$195.70
|
| Rate for Payer: BCN Medicare Advantage |
$120.79
|
| Rate for Payer: Cash Price |
$276.00
|
| Rate for Payer: Cash Price |
$276.00
|
| Rate for Payer: Cofinity Commercial |
$173.94
|
| Rate for Payer: Cofinity Commercial |
$161.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.79
|
| Rate for Payer: Healthscope Commercial |
$144.95
|
| Rate for Payer: Healthscope Whirlpool |
$144.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.83
|
| Rate for Payer: Meridian Medicaid |
$82.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$132.87
|
| Rate for Payer: Nomi Health Commercial |
$144.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.75
|
| Rate for Payer: PACE SWMI |
$120.79
|
| Rate for Payer: PHP Medicare Advantage |
$120.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$238.45
|
| Rate for Payer: Priority Health Medicare |
$120.79
|
| Rate for Payer: Priority Health Narrow Network |
$238.45
|
| Rate for Payer: Railroad Medicare Medicare |
$120.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$227.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$120.79
|
| Rate for Payer: UHC Exchange |
$227.42
|
| Rate for Payer: UHC Medicaid |
$78.81
|
| Rate for Payer: UHCCP DNSP |
$120.79
|
| Rate for Payer: UHCCP Medicaid |
$78.81
|
|
|
PR CUSTOM EAR PLUGS
|
Professional
|
Both
|
$263.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$105.20 |
| Max. Negotiated Rate |
$197.25 |
| Rate for Payer: BCBS Complete |
$105.20
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
|
|
PR CUTANANEOUS APPENDICO-VESICOSTOMY
|
Professional
|
Both
|
$2,665.00
|
|
|
Service Code
|
HCPCS 50845
|
| Min. Negotiated Rate |
$719.73 |
| Max. Negotiated Rate |
$2,209.45 |
| Rate for Payer: Aetna Commercial |
$1,493.31
|
| Rate for Payer: Aetna Medicare |
$1,114.41
|
| Rate for Payer: BCBS Complete |
$755.72
|
| Rate for Payer: BCBS MAPPO |
$1,114.41
|
| Rate for Payer: BCN Commercial |
$1,874.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,114.41
|
| Rate for Payer: Cash Price |
$2,132.00
|
| Rate for Payer: Cash Price |
$2,132.00
|
| Rate for Payer: Cofinity Commercial |
$1,493.31
|
| Rate for Payer: Cofinity Commercial |
$1,604.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,114.41
|
| Rate for Payer: Healthscope Commercial |
$1,337.29
|
| Rate for Payer: Healthscope Whirlpool |
$1,337.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,170.13
|
| Rate for Payer: Meridian Medicaid |
$755.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,225.85
|
| Rate for Payer: Nomi Health Commercial |
$1,337.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,998.75
|
| Rate for Payer: PACE SWMI |
$1,114.41
|
| Rate for Payer: PHP Medicare Advantage |
$1,114.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$719.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2,041.83
|
| Rate for Payer: Priority Health Medicare |
$1,114.41
|
| Rate for Payer: Priority Health Narrow Network |
$2,041.83
|
| Rate for Payer: Railroad Medicare Medicare |
$1,114.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,209.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,114.41
|
| Rate for Payer: UHC Exchange |
$2,209.45
|
| Rate for Payer: UHC Medicaid |
$719.73
|
| Rate for Payer: UHCCP DNSP |
$1,114.41
|
| Rate for Payer: UHCCP Medicaid |
$719.73
|
|
|
PR CUTANEOUS VESICOSTOMY
|
Professional
|
Both
|
$1,504.00
|
|
|
Service Code
|
HCPCS 51980
|
| Min. Negotiated Rate |
$412.58 |
| Max. Negotiated Rate |
$1,257.71 |
| Rate for Payer: Aetna Commercial |
$854.44
|
| Rate for Payer: Aetna Medicare |
$637.64
|
| Rate for Payer: BCBS Complete |
$433.21
|
| Rate for Payer: BCBS MAPPO |
$637.64
|
| Rate for Payer: BCN Commercial |
$1,069.66
|
| Rate for Payer: BCN Medicare Advantage |
$637.64
|
| Rate for Payer: Cash Price |
$1,203.20
|
| Rate for Payer: Cash Price |
$1,203.20
|
| Rate for Payer: Cofinity Commercial |
$918.20
|
| Rate for Payer: Cofinity Commercial |
$854.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.64
|
| Rate for Payer: Healthscope Commercial |
$765.17
|
| Rate for Payer: Healthscope Whirlpool |
$765.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$669.52
|
| Rate for Payer: Meridian Medicaid |
$433.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$701.40
|
| Rate for Payer: Nomi Health Commercial |
$765.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,128.00
|
| Rate for Payer: PACE SWMI |
$637.64
|
| Rate for Payer: PHP Medicare Advantage |
$637.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$412.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,165.21
|
| Rate for Payer: Priority Health Medicare |
$637.64
|
| Rate for Payer: Priority Health Narrow Network |
$1,165.21
|
| Rate for Payer: Railroad Medicare Medicare |
$637.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,257.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$637.64
|
| Rate for Payer: UHC Exchange |
$1,257.71
|
| Rate for Payer: UHC Medicaid |
$412.58
|
| Rate for Payer: UHCCP DNSP |
$637.64
|
| Rate for Payer: UHCCP Medicaid |
$412.58
|
|
|
PR CV STRESS TST XERS&/RX CONT ECG W/SI&R
|
Professional
|
Both
|
$466.00
|
|
|
Service Code
|
HCPCS 93015
|
| Min. Negotiated Rate |
$69.50 |
| Max. Negotiated Rate |
$349.50 |
| Rate for Payer: Aetna Commercial |
$93.13
|
| Rate for Payer: Aetna Medicare |
$69.50
|
| Rate for Payer: BCBS MAPPO |
$69.50
|
| Rate for Payer: BCN Commercial |
$109.06
|
| Rate for Payer: BCN Medicare Advantage |
$69.50
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cofinity Commercial |
$100.08
|
| Rate for Payer: Cofinity Commercial |
$93.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.50
|
| Rate for Payer: Healthscope Commercial |
$83.40
|
| Rate for Payer: Healthscope Whirlpool |
$83.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$76.45
|
| Rate for Payer: Nomi Health Commercial |
$83.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$349.50
|
| Rate for Payer: PACE SWMI |
$69.50
|
| Rate for Payer: PHP Medicare Advantage |
$69.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$103.66
|
| Rate for Payer: Priority Health Medicare |
$69.50
|
| Rate for Payer: Priority Health Narrow Network |
$103.66
|
| Rate for Payer: Railroad Medicare Medicare |
$69.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$110.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$69.50
|
| Rate for Payer: UHC Exchange |
$110.24
|
| Rate for Payer: UHCCP DNSP |
$69.50
|
|
