|
PR COMPRE EP EVAL W/L ATRIAL PACG&REC C SINS/L ATR
|
Professional
|
Both
|
$245.00
|
|
|
Service Code
|
HCPCS 93621
|
| Min. Negotiated Rate |
$50.91 |
| Max. Negotiated Rate |
$1,640.93 |
| Rate for Payer: Aetna Commercial |
$205.99
|
| Rate for Payer: Aetna Medicare |
$122.50
|
| Rate for Payer: BCBS Complete |
$53.46
|
| Rate for Payer: BCBS Trust/PPO |
$1,215.62
|
| Rate for Payer: BCN Commercial |
$1,640.93
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Meridian Medicaid |
$53.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.53
|
| Rate for Payer: Priority Health Narrow Network |
$112.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$442.90
|
| Rate for Payer: UHC Exchange |
$442.90
|
| Rate for Payer: UHCCP Medicaid |
$50.91
|
|
|
PR CONDITIONING PLAY AUDIOMETRY
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 92582
|
| Min. Negotiated Rate |
$43.25 |
| Max. Negotiated Rate |
$2,061.43 |
| Rate for Payer: Aetna Commercial |
$78.02
|
| Rate for Payer: Aetna Medicare |
$65.50
|
| Rate for Payer: BCBS Complete |
$52.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,061.43
|
| Rate for Payer: BCN Commercial |
$119.72
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$117.60
|
| Rate for Payer: Priority Health Narrow Network |
$117.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.25
|
| Rate for Payer: UHC Exchange |
$43.25
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC
|
Facility
|
OP
|
$924.00
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
57522
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$293.81 |
| Max. Negotiated Rate |
$4,828.62 |
| Rate for Payer: Aetna Commercial |
$831.60
|
| Rate for Payer: Aetna Medicare |
$3,115.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: ASR ASR |
$896.28
|
| Rate for Payer: ASR Commercial |
$896.28
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$756.66
|
| Rate for Payer: BCCCP Commercial |
$293.81
|
| Rate for Payer: BCN Commercial |
$716.38
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$868.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$924.00
|
| Rate for Payer: Healthscope Whirlpool |
$896.28
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,115.24
|
| Rate for Payer: Mclaren Commercial |
$831.60
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.40
|
| Rate for Payer: Nomi Health Commercial |
$757.68
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$3,426.76
|
| Rate for Payer: PHP Medicaid |
$1,669.77
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$809.61
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$647.72
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$813.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$4,828.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP DNSP |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: VA VA |
$3,115.24
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC
|
Facility
|
IP
|
$924.00
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
57522
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$600.60 |
| Max. Negotiated Rate |
$924.00 |
| Rate for Payer: Aetna Commercial |
$831.60
|
| Rate for Payer: ASR ASR |
$896.28
|
| Rate for Payer: ASR Commercial |
$896.28
|
| Rate for Payer: BCBS Trust/PPO |
$752.97
|
| Rate for Payer: BCN Commercial |
$716.38
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cofinity Commercial |
$868.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.20
|
| Rate for Payer: Healthscope Commercial |
$924.00
|
| Rate for Payer: Healthscope Whirlpool |
$896.28
|
| Rate for Payer: Mclaren Commercial |
$831.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.40
|
| Rate for Payer: Nomi Health Commercial |
$757.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$813.12
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC
|
Professional
|
Both
|
$924.00
|
|
|
Service Code
|
HCPCS 57522
|
| Min. Negotiated Rate |
$164.65 |
| Max. Negotiated Rate |
$3,117.50 |
| Rate for Payer: Aetna Commercial |
$300.68
|
| Rate for Payer: Aetna Medicare |
$462.00
|
| Rate for Payer: BCBS Complete |
$172.88
|
| Rate for Payer: BCBS Trust/PPO |
$3,117.50
|
| Rate for Payer: BCN Commercial |
$447.14
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Meridian Medicaid |
$172.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$383.95
|
| Rate for Payer: Priority Health Narrow Network |
$383.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$275.06
|
| Rate for Payer: UHC Exchange |
$275.06
|
| Rate for Payer: UHCCP Medicaid |
$164.65
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR ELTRD EXC
|
Professional
|
Both
|
$924.00
|
|
|
Service Code
|
HCPCS 57522
|
| Hospital Charge Code |
57522
|
| Min. Negotiated Rate |
$164.65 |
| Max. Negotiated Rate |
$3,117.50 |
| Rate for Payer: Aetna Commercial |
$300.68
|
| Rate for Payer: Aetna Medicare |
$462.00
|
| Rate for Payer: BCBS Complete |
$172.88
|
| Rate for Payer: BCBS Trust/PPO |
$3,117.50
|
| Rate for Payer: BCN Commercial |
$447.14
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Cash Price |
$739.20
|
| Rate for Payer: Meridian Medicaid |
$172.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$383.95
|
| Rate for Payer: Priority Health Narrow Network |
$383.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$275.06
|
| Rate for Payer: UHC Exchange |
$275.06
|
| Rate for Payer: UHCCP Medicaid |
$164.65
|
|
|
PR CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER
|
Professional
|
Both
|
$1,039.00
|
|
|
Service Code
|
HCPCS 57520
|
| Min. Negotiated Rate |
$191.49 |
| Max. Negotiated Rate |
$1,148.52 |
| Rate for Payer: Aetna Commercial |
$346.33
|
| Rate for Payer: Aetna Medicare |
$519.50
|
| Rate for Payer: BCBS Complete |
$201.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,148.52
|
| Rate for Payer: BCN Commercial |
$520.93
|
| Rate for Payer: Cash Price |
$831.20
|
| Rate for Payer: Cash Price |
$831.20
|
| Rate for Payer: Meridian Medicaid |
$201.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$191.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$446.45
|
| Rate for Payer: Priority Health Narrow Network |
$446.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.20
|
| Rate for Payer: UHC Exchange |
$308.20
|
| Rate for Payer: UHCCP Medicaid |
$191.49
|
|
|
PR CONSTRUCTION ARTIFICIAL VAGINA W/O GRAFT
|
Professional
|
Both
|
$1,701.00
|
|
|
Service Code
|
HCPCS 57291
|
| Min. Negotiated Rate |
$353.37 |
| Max. Negotiated Rate |
$1,525.20 |
| Rate for Payer: Aetna Commercial |
$654.11
|
| Rate for Payer: Aetna Medicare |
$850.50
|
| Rate for Payer: BCBS Complete |
$371.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,525.20
|
| Rate for Payer: BCN Commercial |
$807.78
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Cash Price |
$1,360.80
|
| Rate for Payer: Meridian Medicaid |
$371.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,105.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$825.42
|
| Rate for Payer: Priority Health Narrow Network |
$825.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$616.66
|
| Rate for Payer: UHC Exchange |
$616.66
|
| Rate for Payer: UHCCP Medicaid |
$353.37
|
|
|
PR CONSULTS
|
Professional
|
Both
|
$510.00
|
|
|
Service Code
|
HCPCS 00125
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$204.00 |
| Max. Negotiated Rate |
$331.50 |
| Rate for Payer: Aetna Medicare |
$255.00
|
| Rate for Payer: BCBS Complete |
$204.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.50
|
|
|
PR CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPMENT
|
Professional
|
Both
|
$274.00
|
|
|
Service Code
|
HCPCS 95250
|
| Min. Negotiated Rate |
$109.60 |
| Max. Negotiated Rate |
$424.22 |
| Rate for Payer: Aetna Commercial |
$160.67
|
| Rate for Payer: Aetna Medicare |
$137.00
|
| Rate for Payer: BCBS Complete |
$109.60
|
| Rate for Payer: BCBS Trust/PPO |
$424.22
|
| Rate for Payer: BCN Commercial |
$212.08
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.37
|
| Rate for Payer: Priority Health Narrow Network |
$200.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$134.51
|
| Rate for Payer: UHC Exchange |
$134.51
|
|
|
PR CONT GLUC MONITORING PATIENT PROVIDED EQUIPMENT
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 95249
|
| Min. Negotiated Rate |
$36.80 |
| Max. Negotiated Rate |
$234.04 |
| Rate for Payer: Aetna Commercial |
$59.92
|
| Rate for Payer: Aetna Medicare |
$46.00
|
| Rate for Payer: BCBS Complete |
$36.80
|
| Rate for Payer: BCBS Trust/PPO |
$234.04
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.65
|
| Rate for Payer: Priority Health Narrow Network |
$88.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.24
|
| Rate for Payer: UHC Exchange |
$58.24
|
|
|
PR CONTINENT DVRJ W/INT ANAST ANY SGM SM&/LG INTSTN
|
Professional
|
Both
|
$3,434.00
|
|
|
Service Code
|
HCPCS 50825
|
| Min. Negotiated Rate |
$1,047.11 |
| Max. Negotiated Rate |
$3,355.23 |
| Rate for Payer: Aetna Commercial |
$2,127.62
|
| Rate for Payer: Aetna Medicare |
$1,717.00
|
| Rate for Payer: BCBS Complete |
$1,099.47
|
| Rate for Payer: BCBS Trust/PPO |
$3,355.23
|
| Rate for Payer: BCN Commercial |
$2,362.27
|
| Rate for Payer: Cash Price |
$2,747.20
|
| Rate for Payer: Cash Price |
$2,747.20
|
| Rate for Payer: Meridian Medicaid |
$1,099.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,047.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,232.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,601.74
|
| Rate for Payer: Priority Health Narrow Network |
$2,601.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,997.40
|
| Rate for Payer: UHC Exchange |
$1,997.40
|
| Rate for Payer: UHCCP Medicaid |
$1,047.11
|
|
|
PR CONTINENT ILEOSTOMY KOCK PROCEDURE SPX
|
Professional
|
Both
|
$4,041.00
|
|
|
Service Code
|
HCPCS 44316
|
| Min. Negotiated Rate |
$202.06 |
| Max. Negotiated Rate |
$2,626.65 |
| Rate for Payer: Aetna Commercial |
$1,914.59
|
| Rate for Payer: Aetna Medicare |
$2,020.50
|
| Rate for Payer: BCBS Complete |
$954.53
|
| Rate for Payer: BCBS Trust/PPO |
$202.06
|
| Rate for Payer: BCN Commercial |
$2,064.66
|
| Rate for Payer: Cash Price |
$3,232.80
|
| Rate for Payer: Cash Price |
$3,232.80
|
| Rate for Payer: Meridian Medicaid |
$954.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$909.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,626.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,533.14
|
| Rate for Payer: Priority Health Narrow Network |
$2,533.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,698.09
|
| Rate for Payer: UHC Exchange |
$1,698.09
|
| Rate for Payer: UHCCP Medicaid |
$909.08
|
|
|
PR CONT INTRAOP NEURO MONITOR
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS G0453
|
| Min. Negotiated Rate |
$29.56 |
| Max. Negotiated Rate |
$1,643.01 |
| Rate for Payer: Aetna Commercial |
$32.50
|
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,643.01
|
| Rate for Payer: BCN Commercial |
$45.94
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.97
|
| Rate for Payer: Priority Health Narrow Network |
$42.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.56
|
| Rate for Payer: UHC Exchange |
$29.56
|
|
|
PR CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R
|
Professional
|
Both
|
$74.00
|
|
|
Service Code
|
HCPCS 95251
|
| Min. Negotiated Rate |
$21.94 |
| Max. Negotiated Rate |
$534.11 |
| Rate for Payer: Aetna Commercial |
$38.86
|
| Rate for Payer: Aetna Medicare |
$37.00
|
| Rate for Payer: BCBS Complete |
$23.04
|
| Rate for Payer: BCBS Trust/PPO |
$534.11
|
| Rate for Payer: BCN Commercial |
$49.85
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Meridian Medicaid |
$23.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.59
|
| Rate for Payer: Priority Health Narrow Network |
$46.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.85
|
| Rate for Payer: UHC Exchange |
$43.85
|
| Rate for Payer: UHCCP Medicaid |
$21.94
|
|
|
PR CONTINUOUS INHALATION TREATMENT 1ST HR
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 94644
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$270.49 |
| Rate for Payer: Aetna Commercial |
$62.69
|
| Rate for Payer: Aetna Medicare |
$42.00
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS Trust/PPO |
$270.49
|
| Rate for Payer: BCN Commercial |
$86.99
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.96
|
| Rate for Payer: Priority Health Narrow Network |
$80.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.81
|
| Rate for Payer: UHC Exchange |
$35.81
|
|
|
PR CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 49465
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$1,618.71 |
| Rate for Payer: Aetna Commercial |
$40.95
|
| Rate for Payer: Aetna Medicare |
$31.00
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,618.71
|
| Rate for Payer: BCN Commercial |
$200.85
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Meridian Medicaid |
$19.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.10
|
| Rate for Payer: Priority Health Narrow Network |
$53.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.78
|
| Rate for Payer: UHC Exchange |
$40.78
|
| Rate for Payer: UHCCP Medicaid |
$18.96
|
|
|
PR CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX
|
Professional
|
Both
|
$396.00
|
|
|
Service Code
|
HCPCS 30903
|
| Min. Negotiated Rate |
$49.42 |
| Max. Negotiated Rate |
$798.79 |
| Rate for Payer: Aetna Commercial |
$100.82
|
| Rate for Payer: Aetna Medicare |
$198.00
|
| Rate for Payer: BCBS Complete |
$51.89
|
| Rate for Payer: BCBS Trust/PPO |
$798.79
|
| Rate for Payer: BCN Commercial |
$363.58
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Meridian Medicaid |
$51.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$106.60
|
| Rate for Payer: Priority Health Narrow Network |
$106.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$93.51
|
| Rate for Payer: UHC Exchange |
$93.51
|
| Rate for Payer: UHCCP Medicaid |
$49.42
|
|
|
PR CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE
|
Professional
|
Both
|
$264.00
|
|
|
Service Code
|
HCPCS 30901
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$897.05 |
| Rate for Payer: Aetna Commercial |
$72.74
|
| Rate for Payer: Aetna Medicare |
$132.00
|
| Rate for Payer: BCBS Complete |
$37.80
|
| Rate for Payer: BCBS Trust/PPO |
$897.05
|
| Rate for Payer: BCN Commercial |
$232.12
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Meridian Medicaid |
$37.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.33
|
| Rate for Payer: Priority Health Narrow Network |
$78.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.55
|
| Rate for Payer: UHC Exchange |
$71.55
|
| Rate for Payer: UHCCP Medicaid |
$36.00
|
|
|
PR CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE
|
Professional
|
Both
|
$326.00
|
|
|
Service Code
|
HCPCS 42960
|
| Min. Negotiated Rate |
$104.37 |
| Max. Negotiated Rate |
$290.54 |
| Rate for Payer: Aetna Commercial |
$214.84
|
| Rate for Payer: Aetna Medicare |
$163.00
|
| Rate for Payer: BCBS Complete |
$109.59
|
| Rate for Payer: BCBS Trust/PPO |
$278.94
|
| Rate for Payer: BCN Commercial |
$235.54
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Meridian Medicaid |
$109.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$290.54
|
| Rate for Payer: Priority Health Narrow Network |
$290.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$206.31
|
| Rate for Payer: UHC Exchange |
$206.31
|
| Rate for Payer: UHCCP Medicaid |
$104.37
|
|
|
PR CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ
|
Professional
|
Both
|
$2,096.00
|
|
|
Service Code
|
HCPCS 49446
|
| Min. Negotiated Rate |
$91.59 |
| Max. Negotiated Rate |
$1,362.40 |
| Rate for Payer: Aetna Commercial |
$196.04
|
| Rate for Payer: Aetna Medicare |
$1,048.00
|
| Rate for Payer: BCBS Complete |
$96.17
|
| Rate for Payer: BCBS Trust/PPO |
$605.43
|
| Rate for Payer: BCN Commercial |
$1,182.11
|
| Rate for Payer: Cash Price |
$1,676.80
|
| Rate for Payer: Cash Price |
$1,676.80
|
| Rate for Payer: Meridian Medicaid |
$96.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,362.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.14
|
| Rate for Payer: Priority Health Narrow Network |
$254.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$218.58
|
| Rate for Payer: UHC Exchange |
$218.58
|
| Rate for Payer: UHCCP Medicaid |
$91.59
|
|
|
PR CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT
|
Professional
|
Both
|
$3,455.00
|
|
|
Service Code
|
HCPCS 27132
|
| Min. Negotiated Rate |
$429.51 |
| Max. Negotiated Rate |
$2,552.44 |
| Rate for Payer: Aetna Commercial |
$2,237.15
|
| Rate for Payer: Aetna Medicare |
$1,727.50
|
| Rate for Payer: BCBS Complete |
$1,130.56
|
| Rate for Payer: BCBS Trust/PPO |
$429.51
|
| Rate for Payer: BCN Commercial |
$2,437.03
|
| Rate for Payer: Cash Price |
$2,764.00
|
| Rate for Payer: Cash Price |
$2,764.00
|
| Rate for Payer: Meridian Medicaid |
$1,130.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,076.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,245.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,552.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,552.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,963.69
|
| Rate for Payer: UHC Exchange |
$1,963.69
|
| Rate for Payer: UHCCP Medicaid |
$1,076.72
|
|
|
PR CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY
|
Professional
|
Both
|
$1,775.00
|
|
|
Service Code
|
HCPCS 23415
|
| Min. Negotiated Rate |
$94.66 |
| Max. Negotiated Rate |
$1,153.75 |
| Rate for Payer: Aetna Commercial |
$929.83
|
| Rate for Payer: Aetna Medicare |
$887.50
|
| Rate for Payer: BCBS Complete |
$481.52
|
| Rate for Payer: BCBS Trust/PPO |
$94.66
|
| Rate for Payer: BCN Commercial |
$1,030.14
|
| Rate for Payer: Cash Price |
$1,420.00
|
| Rate for Payer: Cash Price |
$1,420.00
|
| Rate for Payer: Meridian Medicaid |
$481.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$458.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,153.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,081.83
|
| Rate for Payer: Priority Health Narrow Network |
$1,081.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$789.25
|
| Rate for Payer: UHC Exchange |
$789.25
|
| Rate for Payer: UHCCP Medicaid |
$458.59
|
|
|
PR CORDOCENTESIS INTRAUTERINE
|
Professional
|
Both
|
$536.00
|
|
|
Service Code
|
HCPCS 59012
|
| Min. Negotiated Rate |
$128.44 |
| Max. Negotiated Rate |
$556.83 |
| Rate for Payer: Aetna Commercial |
$220.91
|
| Rate for Payer: Aetna Medicare |
$268.00
|
| Rate for Payer: BCBS Complete |
$134.86
|
| Rate for Payer: BCBS Trust/PPO |
$556.83
|
| Rate for Payer: BCN Commercial |
$293.70
|
| Rate for Payer: Cash Price |
$428.80
|
| Rate for Payer: Cash Price |
$428.80
|
| Rate for Payer: Meridian Medicaid |
$134.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$281.79
|
| Rate for Payer: Priority Health Narrow Network |
$281.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$234.88
|
| Rate for Payer: UHC Exchange |
$234.88
|
| Rate for Payer: UHCCP Medicaid |
$128.44
|
|
|
PR CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG
|
Professional
|
Both
|
$370.00
|
|
|
Service Code
|
HCPCS 32408
|
| Min. Negotiated Rate |
$95.21 |
| Max. Negotiated Rate |
$1,267.14 |
| Rate for Payer: Aetna Commercial |
$197.12
|
| Rate for Payer: Aetna Medicare |
$185.00
|
| Rate for Payer: BCBS Complete |
$99.97
|
| Rate for Payer: BCN Commercial |
$1,267.14
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Meridian Medicaid |
$99.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$206.70
|
| Rate for Payer: Priority Health Narrow Network |
$206.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$187.68
|
| Rate for Payer: UHC Exchange |
$187.68
|
| Rate for Payer: UHCCP Medicaid |
$95.21
|
|
