|
PR NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY
|
Professional
|
Both
|
$728.00
|
|
|
Service Code
|
HCPCS 31254
|
| Min. Negotiated Rate |
$154.43 |
| Max. Negotiated Rate |
$1,345.05 |
| Rate for Payer: Aetna Commercial |
$320.77
|
| Rate for Payer: Aetna Medicare |
$239.38
|
| Rate for Payer: BCBS Complete |
$162.15
|
| Rate for Payer: BCBS MAPPO |
$239.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,345.05
|
| Rate for Payer: BCN Commercial |
$646.03
|
| Rate for Payer: BCN Medicare Advantage |
$239.38
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Cofinity Commercial |
$344.71
|
| Rate for Payer: Cofinity Commercial |
$320.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.38
|
| Rate for Payer: Healthscope Commercial |
$287.26
|
| Rate for Payer: Healthscope Whirlpool |
$287.26
|
| Rate for Payer: Meridian Medicaid |
$162.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$251.35
|
| Rate for Payer: PACE SWMI |
$239.38
|
| Rate for Payer: PHP Medicare Advantage |
$239.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$334.78
|
| Rate for Payer: Priority Health Medicare |
$239.38
|
| Rate for Payer: Priority Health Narrow Network |
$334.78
|
| Rate for Payer: UHC Medicare Advantage |
$246.56
|
|
|
PR NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS
|
Professional
|
Both
|
$1,333.00
|
|
|
Service Code
|
HCPCS 31276
|
| Min. Negotiated Rate |
$240.05 |
| Max. Negotiated Rate |
$1,458.11 |
| Rate for Payer: Aetna Commercial |
$499.03
|
| Rate for Payer: Aetna Medicare |
$372.41
|
| Rate for Payer: BCBS Complete |
$252.05
|
| Rate for Payer: BCBS MAPPO |
$372.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,458.11
|
| Rate for Payer: BCN Commercial |
$548.78
|
| Rate for Payer: BCN Medicare Advantage |
$372.41
|
| Rate for Payer: Cash Price |
$1,066.40
|
| Rate for Payer: Cash Price |
$1,066.40
|
| Rate for Payer: Cofinity Commercial |
$499.03
|
| Rate for Payer: Cofinity Commercial |
$536.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$372.41
|
| Rate for Payer: Healthscope Commercial |
$446.89
|
| Rate for Payer: Healthscope Whirlpool |
$446.89
|
| Rate for Payer: Meridian Medicaid |
$252.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$391.03
|
| Rate for Payer: PACE SWMI |
$372.41
|
| Rate for Payer: PHP Medicare Advantage |
$372.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$240.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$933.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$520.00
|
| Rate for Payer: Priority Health Medicare |
$372.41
|
| Rate for Payer: Priority Health Narrow Network |
$520.00
|
| Rate for Payer: UHC Medicare Advantage |
$383.58
|
|
|
PR NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY
|
Professional
|
Both
|
$926.00
|
|
|
Service Code
|
HCPCS 31255
|
| Min. Negotiated Rate |
$205.12 |
| Max. Negotiated Rate |
$1,500.90 |
| Rate for Payer: Aetna Commercial |
$427.34
|
| Rate for Payer: Aetna Medicare |
$318.91
|
| Rate for Payer: BCBS Complete |
$215.38
|
| Rate for Payer: BCBS MAPPO |
$318.91
|
| Rate for Payer: BCBS Trust/PPO |
$1,500.90
|
| Rate for Payer: BCN Commercial |
$470.10
|
| Rate for Payer: BCN Medicare Advantage |
$318.91
|
| Rate for Payer: Cash Price |
$740.80
|
| Rate for Payer: Cash Price |
$740.80
|
| Rate for Payer: Cofinity Commercial |
$459.23
|
| Rate for Payer: Cofinity Commercial |
$427.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.91
|
| Rate for Payer: Healthscope Commercial |
$382.69
|
| Rate for Payer: Healthscope Whirlpool |
$382.69
|
| Rate for Payer: Meridian Medicaid |
$215.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$334.86
|
| Rate for Payer: PACE SWMI |
$318.91
|
| Rate for Payer: PHP Medicare Advantage |
$318.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$648.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$445.44
|
| Rate for Payer: Priority Health Medicare |
$318.91
|
| Rate for Payer: Priority Health Narrow Network |
$445.44
|
| Rate for Payer: UHC Medicare Advantage |
$328.48
|
|
|
PR NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 43752
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$1,612.37 |
| Rate for Payer: Aetna Commercial |
$53.25
|
| Rate for Payer: Aetna Medicare |
$39.74
|
| Rate for Payer: BCBS Complete |
$26.39
|
| Rate for Payer: BCBS MAPPO |
$39.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,612.37
|
| Rate for Payer: BCN Commercial |
$58.15
|
| Rate for Payer: BCN Medicare Advantage |
$39.74
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$57.23
|
| Rate for Payer: Cofinity Commercial |
$53.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.74
|
| Rate for Payer: Healthscope Commercial |
$47.69
|
| Rate for Payer: Healthscope Whirlpool |
$47.69
|
| Rate for Payer: Meridian Medicaid |
$26.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.73
|
| Rate for Payer: PACE SWMI |
$39.74
|
| Rate for Payer: PHP Medicare Advantage |
$39.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.98
|
| Rate for Payer: Priority Health Medicare |
$39.74
|
| Rate for Payer: Priority Health Narrow Network |
$69.98
|
| Rate for Payer: UHC Medicare Advantage |
$40.93
|
|
|
PR NASOPHARYNGOSCOPY W/ENDOSCOPE SPX
|
Professional
|
Both
|
$226.00
|
|
|
Service Code
|
HCPCS 92511
|
| Min. Negotiated Rate |
$24.07 |
| Max. Negotiated Rate |
$552.07 |
| Rate for Payer: Aetna Commercial |
$49.10
|
| Rate for Payer: Aetna Medicare |
$36.64
|
| Rate for Payer: BCBS Complete |
$25.27
|
| Rate for Payer: BCBS MAPPO |
$36.64
|
| Rate for Payer: BCBS Trust/PPO |
$552.07
|
| Rate for Payer: BCN Commercial |
$139.00
|
| Rate for Payer: BCN Medicare Advantage |
$36.64
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$52.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.64
|
| Rate for Payer: Healthscope Commercial |
$43.97
|
| Rate for Payer: Healthscope Whirlpool |
$43.97
|
| Rate for Payer: Meridian Medicaid |
$25.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.47
|
| Rate for Payer: PACE SWMI |
$36.64
|
| Rate for Payer: PHP Medicare Advantage |
$36.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.30
|
| Rate for Payer: Priority Health Medicare |
$36.64
|
| Rate for Payer: Priority Health Narrow Network |
$50.30
|
| Rate for Payer: UHC Medicare Advantage |
$37.74
|
|
|
PR NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS
|
Professional
|
Both
|
$211.00
|
|
|
Service Code
|
HCPCS 95860
|
| Min. Negotiated Rate |
$84.40 |
| Max. Negotiated Rate |
$1,210.86 |
| Rate for Payer: Aetna Commercial |
$142.83
|
| Rate for Payer: Aetna Medicare |
$106.59
|
| Rate for Payer: BCBS Complete |
$84.40
|
| Rate for Payer: BCBS MAPPO |
$106.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,210.86
|
| Rate for Payer: BCN Commercial |
$163.71
|
| Rate for Payer: BCN Medicare Advantage |
$106.59
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cash Price |
$168.80
|
| Rate for Payer: Cofinity Commercial |
$153.49
|
| Rate for Payer: Cofinity Commercial |
$142.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.59
|
| Rate for Payer: Healthscope Commercial |
$127.91
|
| Rate for Payer: Healthscope Whirlpool |
$127.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$111.92
|
| Rate for Payer: PACE SWMI |
$106.59
|
| Rate for Payer: PHP Medicare Advantage |
$106.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.46
|
| Rate for Payer: Priority Health Medicare |
$106.59
|
| Rate for Payer: Priority Health Narrow Network |
$150.46
|
| Rate for Payer: UHC Medicare Advantage |
$109.79
|
|
|
PR NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS
|
Professional
|
Both
|
$290.00
|
|
|
Service Code
|
HCPCS 95861
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$1,443.84 |
| Rate for Payer: Aetna Commercial |
$204.98
|
| Rate for Payer: Aetna Medicare |
$152.97
|
| Rate for Payer: BCBS Complete |
$116.00
|
| Rate for Payer: BCBS MAPPO |
$152.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,443.84
|
| Rate for Payer: BCN Commercial |
$234.08
|
| Rate for Payer: BCN Medicare Advantage |
$152.97
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$220.28
|
| Rate for Payer: Cofinity Commercial |
$204.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.97
|
| Rate for Payer: Healthscope Commercial |
$183.56
|
| Rate for Payer: Healthscope Whirlpool |
$183.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$160.62
|
| Rate for Payer: PACE SWMI |
$152.97
|
| Rate for Payer: PHP Medicare Advantage |
$152.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.14
|
| Rate for Payer: Priority Health Medicare |
$152.97
|
| Rate for Payer: Priority Health Narrow Network |
$215.14
|
| Rate for Payer: UHC Medicare Advantage |
$157.56
|
|
|
PR NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS
|
Professional
|
Both
|
$354.00
|
|
|
Service Code
|
HCPCS 95863
|
| Min. Negotiated Rate |
$141.60 |
| Max. Negotiated Rate |
$706.87 |
| Rate for Payer: Aetna Commercial |
$265.53
|
| Rate for Payer: Aetna Medicare |
$198.16
|
| Rate for Payer: BCBS Complete |
$141.60
|
| Rate for Payer: BCBS MAPPO |
$198.16
|
| Rate for Payer: BCBS Trust/PPO |
$706.87
|
| Rate for Payer: BCN Commercial |
$303.96
|
| Rate for Payer: BCN Medicare Advantage |
$198.16
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cofinity Commercial |
$285.35
|
| Rate for Payer: Cofinity Commercial |
$265.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.16
|
| Rate for Payer: Healthscope Commercial |
$237.79
|
| Rate for Payer: Healthscope Whirlpool |
$237.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$208.07
|
| Rate for Payer: PACE SWMI |
$198.16
|
| Rate for Payer: PHP Medicare Advantage |
$198.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$279.37
|
| Rate for Payer: Priority Health Medicare |
$198.16
|
| Rate for Payer: Priority Health Narrow Network |
$279.37
|
| Rate for Payer: UHC Medicare Advantage |
$204.10
|
|
|
PR NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS
|
Professional
|
Both
|
$405.00
|
|
|
Service Code
|
HCPCS 95864
|
| Min. Negotiated Rate |
$162.00 |
| Max. Negotiated Rate |
$953.58 |
| Rate for Payer: Aetna Commercial |
$297.20
|
| Rate for Payer: Aetna Medicare |
$221.79
|
| Rate for Payer: BCBS Complete |
$162.00
|
| Rate for Payer: BCBS MAPPO |
$221.79
|
| Rate for Payer: BCBS Trust/PPO |
$953.58
|
| Rate for Payer: BCN Commercial |
$340.61
|
| Rate for Payer: BCN Medicare Advantage |
$221.79
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Cofinity Commercial |
$319.38
|
| Rate for Payer: Cofinity Commercial |
$297.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.79
|
| Rate for Payer: Healthscope Commercial |
$266.15
|
| Rate for Payer: Healthscope Whirlpool |
$266.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$232.88
|
| Rate for Payer: PACE SWMI |
$221.79
|
| Rate for Payer: PHP Medicare Advantage |
$221.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$283.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$313.05
|
| Rate for Payer: Priority Health Medicare |
$221.79
|
| Rate for Payer: Priority Health Narrow Network |
$313.05
|
| Rate for Payer: UHC Medicare Advantage |
$228.44
|
|
|
PR NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX
|
Professional
|
Both
|
$856.00
|
|
|
Service Code
|
HCPCS 44385
|
| Min. Negotiated Rate |
$46.22 |
| Max. Negotiated Rate |
$1,990.63 |
| Rate for Payer: Aetna Commercial |
$95.56
|
| Rate for Payer: Aetna Medicare |
$71.31
|
| Rate for Payer: BCBS Complete |
$48.53
|
| Rate for Payer: BCBS MAPPO |
$71.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,990.63
|
| Rate for Payer: BCN Commercial |
$317.65
|
| Rate for Payer: BCN Medicare Advantage |
$71.31
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cash Price |
$684.80
|
| Rate for Payer: Cofinity Commercial |
$95.56
|
| Rate for Payer: Cofinity Commercial |
$102.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.31
|
| Rate for Payer: Healthscope Commercial |
$85.57
|
| Rate for Payer: Healthscope Whirlpool |
$85.57
|
| Rate for Payer: Meridian Medicaid |
$48.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$74.88
|
| Rate for Payer: PACE SWMI |
$71.31
|
| Rate for Payer: PHP Medicare Advantage |
$71.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$127.01
|
| Rate for Payer: Priority Health Medicare |
$71.31
|
| Rate for Payer: Priority Health Narrow Network |
$127.01
|
| Rate for Payer: UHC Medicare Advantage |
$73.45
|
|
|
PR NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,018.00
|
|
|
Service Code
|
HCPCS 44386
|
| Min. Negotiated Rate |
$56.45 |
| Max. Negotiated Rate |
$3,257.50 |
| Rate for Payer: Aetna Commercial |
$116.29
|
| Rate for Payer: Aetna Medicare |
$86.78
|
| Rate for Payer: BCBS Complete |
$59.27
|
| Rate for Payer: BCBS MAPPO |
$86.78
|
| Rate for Payer: BCBS Trust/PPO |
$3,257.50
|
| Rate for Payer: BCN Commercial |
$458.38
|
| Rate for Payer: BCN Medicare Advantage |
$86.78
|
| Rate for Payer: Cash Price |
$814.40
|
| Rate for Payer: Cash Price |
$814.40
|
| Rate for Payer: Cofinity Commercial |
$116.29
|
| Rate for Payer: Cofinity Commercial |
$124.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.78
|
| Rate for Payer: Healthscope Commercial |
$104.14
|
| Rate for Payer: Healthscope Whirlpool |
$104.14
|
| Rate for Payer: Meridian Medicaid |
$59.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$91.12
|
| Rate for Payer: PACE SWMI |
$86.78
|
| Rate for Payer: PHP Medicare Advantage |
$86.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.63
|
| Rate for Payer: Priority Health Medicare |
$86.78
|
| Rate for Payer: Priority Health Narrow Network |
$154.63
|
| Rate for Payer: UHC Medicare Advantage |
$89.38
|
|
|
PR NDSC NJX IMPLT MATRL URT&/BLDR NCK
|
Professional
|
Both
|
$1,715.00
|
|
|
Service Code
|
HCPCS 51715
|
| Min. Negotiated Rate |
$126.10 |
| Max. Negotiated Rate |
$2,071.46 |
| Rate for Payer: Aetna Commercial |
$262.13
|
| Rate for Payer: Aetna Medicare |
$195.62
|
| Rate for Payer: BCBS Complete |
$132.40
|
| Rate for Payer: BCBS MAPPO |
$195.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,071.46
|
| Rate for Payer: BCN Commercial |
$544.39
|
| Rate for Payer: BCN Medicare Advantage |
$195.62
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cash Price |
$1,372.00
|
| Rate for Payer: Cofinity Commercial |
$281.69
|
| Rate for Payer: Cofinity Commercial |
$262.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.62
|
| Rate for Payer: Healthscope Commercial |
$234.74
|
| Rate for Payer: Healthscope Whirlpool |
$234.74
|
| Rate for Payer: Meridian Medicaid |
$132.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$205.40
|
| Rate for Payer: PACE SWMI |
$195.62
|
| Rate for Payer: PHP Medicare Advantage |
$195.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,200.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$317.74
|
| Rate for Payer: Priority Health Medicare |
$195.62
|
| Rate for Payer: Priority Health Narrow Network |
$317.74
|
| Rate for Payer: UHC Medicare Advantage |
$201.49
|
|
|
PR NDSC SURG W/VIDEO-ASSISTED HARVEST VEIN CABG
|
Professional
|
Both
|
$335.00
|
|
|
Service Code
|
HCPCS 33508
|
| Min. Negotiated Rate |
$10.01 |
| Max. Negotiated Rate |
$878.56 |
| Rate for Payer: Aetna Commercial |
$21.23
|
| Rate for Payer: Aetna Medicare |
$15.84
|
| Rate for Payer: BCBS Complete |
$10.51
|
| Rate for Payer: BCBS MAPPO |
$15.84
|
| Rate for Payer: BCBS Trust/PPO |
$878.56
|
| Rate for Payer: BCN Commercial |
$22.97
|
| Rate for Payer: BCN Medicare Advantage |
$15.84
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cash Price |
$268.00
|
| Rate for Payer: Cofinity Commercial |
$22.81
|
| Rate for Payer: Cofinity Commercial |
$21.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.84
|
| Rate for Payer: Healthscope Commercial |
$19.01
|
| Rate for Payer: Healthscope Whirlpool |
$19.01
|
| Rate for Payer: Meridian Medicaid |
$10.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.63
|
| Rate for Payer: PACE SWMI |
$15.84
|
| Rate for Payer: PHP Medicare Advantage |
$15.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.01
|
| Rate for Payer: Priority Health Medicare |
$15.84
|
| Rate for Payer: Priority Health Narrow Network |
$25.01
|
| Rate for Payer: UHC Medicare Advantage |
$16.32
|
|
|
PR NDSC URETEROTOMY RMVL FB/CALCULUS
|
Professional
|
Both
|
$677.00
|
|
|
Service Code
|
HCPCS 50980
|
| Min. Negotiated Rate |
$223.22 |
| Max. Negotiated Rate |
$2,962.71 |
| Rate for Payer: Aetna Commercial |
$463.60
|
| Rate for Payer: Aetna Medicare |
$345.97
|
| Rate for Payer: BCBS Complete |
$234.38
|
| Rate for Payer: BCBS MAPPO |
$345.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,962.71
|
| Rate for Payer: BCN Commercial |
$507.73
|
| Rate for Payer: BCN Medicare Advantage |
$345.97
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cash Price |
$541.60
|
| Rate for Payer: Cofinity Commercial |
$498.20
|
| Rate for Payer: Cofinity Commercial |
$463.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.97
|
| Rate for Payer: Healthscope Commercial |
$415.16
|
| Rate for Payer: Healthscope Whirlpool |
$415.16
|
| Rate for Payer: Meridian Medicaid |
$234.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$363.27
|
| Rate for Payer: PACE SWMI |
$345.97
|
| Rate for Payer: PHP Medicare Advantage |
$345.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$561.44
|
| Rate for Payer: Priority Health Medicare |
$345.97
|
| Rate for Payer: Priority Health Narrow Network |
$561.44
|
| Rate for Payer: UHC Medicare Advantage |
$356.35
|
|
|
PR NDSC URETEROTOMY URTRL CATHJ W/WO DILAT URETER
|
Professional
|
Both
|
$679.00
|
|
|
Service Code
|
HCPCS 50972
|
| Min. Negotiated Rate |
$224.29 |
| Max. Negotiated Rate |
$2,720.22 |
| Rate for Payer: Aetna Commercial |
$466.24
|
| Rate for Payer: Aetna Medicare |
$347.94
|
| Rate for Payer: BCBS Complete |
$235.50
|
| Rate for Payer: BCBS MAPPO |
$347.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,720.22
|
| Rate for Payer: BCN Commercial |
$510.66
|
| Rate for Payer: BCN Medicare Advantage |
$347.94
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cash Price |
$543.20
|
| Rate for Payer: Cofinity Commercial |
$501.03
|
| Rate for Payer: Cofinity Commercial |
$466.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$347.94
|
| Rate for Payer: Healthscope Commercial |
$417.53
|
| Rate for Payer: Healthscope Whirlpool |
$417.53
|
| Rate for Payer: Meridian Medicaid |
$235.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$365.34
|
| Rate for Payer: PACE SWMI |
$347.94
|
| Rate for Payer: PHP Medicare Advantage |
$347.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$475.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$564.67
|
| Rate for Payer: Priority Health Medicare |
$347.94
|
| Rate for Payer: Priority Health Narrow Network |
$564.67
|
| Rate for Payer: UHC Medicare Advantage |
$358.38
|
|
|
PR NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM
|
Professional
|
Both
|
$1,840.00
|
|
|
Service Code
|
HCPCS 29848
|
| Min. Negotiated Rate |
$333.98 |
| Max. Negotiated Rate |
$1,288.00 |
| Rate for Payer: Aetna Commercial |
$675.11
|
| Rate for Payer: Aetna Medicare |
$503.81
|
| Rate for Payer: BCBS Complete |
$350.68
|
| Rate for Payer: BCBS MAPPO |
$503.81
|
| Rate for Payer: BCBS Trust/PPO |
$571.09
|
| Rate for Payer: BCN Commercial |
$756.47
|
| Rate for Payer: BCN Medicare Advantage |
$503.81
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cash Price |
$1,472.00
|
| Rate for Payer: Cofinity Commercial |
$725.49
|
| Rate for Payer: Cofinity Commercial |
$675.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$503.81
|
| Rate for Payer: Healthscope Commercial |
$604.57
|
| Rate for Payer: Healthscope Whirlpool |
$604.57
|
| Rate for Payer: Meridian Medicaid |
$350.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$529.00
|
| Rate for Payer: PACE SWMI |
$503.81
|
| Rate for Payer: PHP Medicare Advantage |
$503.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$333.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,288.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$790.48
|
| Rate for Payer: Priority Health Medicare |
$503.81
|
| Rate for Payer: Priority Health Narrow Network |
$790.48
|
| Rate for Payer: UHC Medicare Advantage |
$518.92
|
|
|
PR NECK LIFT
|
Professional
|
Both
|
$2,000.00
|
|
|
Service Code
|
HCPCS 00541
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$800.00 |
| Max. Negotiated Rate |
$1,400.00 |
| Rate for Payer: BCBS Complete |
$800.00
|
| Rate for Payer: Cash Price |
$1,600.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,400.00
|
|
|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI
|
Professional
|
Both
|
$264.00
|
|
|
Service Code
|
HCPCS 95868
|
| Min. Negotiated Rate |
$105.60 |
| Max. Negotiated Rate |
$284.75 |
| Rate for Payer: Aetna Commercial |
$177.23
|
| Rate for Payer: Aetna Medicare |
$132.26
|
| Rate for Payer: BCBS Complete |
$105.60
|
| Rate for Payer: BCBS MAPPO |
$132.26
|
| Rate for Payer: BCBS Trust/PPO |
$284.75
|
| Rate for Payer: BCN Commercial |
$203.29
|
| Rate for Payer: BCN Medicare Advantage |
$132.26
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$190.45
|
| Rate for Payer: Cofinity Commercial |
$177.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.26
|
| Rate for Payer: Healthscope Commercial |
$158.71
|
| Rate for Payer: Healthscope Whirlpool |
$158.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$138.87
|
| Rate for Payer: PACE SWMI |
$132.26
|
| Rate for Payer: PHP Medicare Advantage |
$132.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.84
|
| Rate for Payer: Priority Health Medicare |
$132.26
|
| Rate for Payer: Priority Health Narrow Network |
$186.84
|
| Rate for Payer: UHC Medicare Advantage |
$136.23
|
|
|
PR NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
HCPCS 95867
|
| Min. Negotiated Rate |
$76.40 |
| Max. Negotiated Rate |
$620.75 |
| Rate for Payer: Aetna Commercial |
$135.94
|
| Rate for Payer: Aetna Medicare |
$101.45
|
| Rate for Payer: BCBS Complete |
$76.40
|
| Rate for Payer: BCBS MAPPO |
$101.45
|
| Rate for Payer: BCBS Trust/PPO |
$620.75
|
| Rate for Payer: BCN Commercial |
$156.38
|
| Rate for Payer: BCN Medicare Advantage |
$101.45
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cofinity Commercial |
$135.94
|
| Rate for Payer: Cofinity Commercial |
$146.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.45
|
| Rate for Payer: Healthscope Commercial |
$121.74
|
| Rate for Payer: Healthscope Whirlpool |
$121.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$106.52
|
| Rate for Payer: PACE SWMI |
$101.45
|
| Rate for Payer: PHP Medicare Advantage |
$101.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.73
|
| Rate for Payer: Priority Health Medicare |
$101.45
|
| Rate for Payer: Priority Health Narrow Network |
$143.73
|
| Rate for Payer: UHC Medicare Advantage |
$104.49
|
|
|
PR NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM
|
Professional
|
Both
|
$232.00
|
|
|
Service Code
|
HCPCS 95866
|
| Min. Negotiated Rate |
$92.80 |
| Max. Negotiated Rate |
$665.13 |
| Rate for Payer: Aetna Commercial |
$161.79
|
| Rate for Payer: Aetna Medicare |
$120.74
|
| Rate for Payer: BCBS Complete |
$92.80
|
| Rate for Payer: BCBS MAPPO |
$120.74
|
| Rate for Payer: BCBS Trust/PPO |
$665.13
|
| Rate for Payer: BCN Commercial |
$184.72
|
| Rate for Payer: BCN Medicare Advantage |
$120.74
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cofinity Commercial |
$161.79
|
| Rate for Payer: Cofinity Commercial |
$173.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.74
|
| Rate for Payer: Healthscope Commercial |
$144.89
|
| Rate for Payer: Healthscope Whirlpool |
$144.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.78
|
| Rate for Payer: PACE SWMI |
$120.74
|
| Rate for Payer: PHP Medicare Advantage |
$120.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.77
|
| Rate for Payer: Priority Health Medicare |
$120.74
|
| Rate for Payer: Priority Health Narrow Network |
$169.77
|
| Rate for Payer: UHC Medicare Advantage |
$124.36
|
|
|
PR NEEDLE ELECTROMYOGRAPHY LARYNX
|
Professional
|
Both
|
$365.00
|
|
|
Service Code
|
HCPCS 95865
|
| Min. Negotiated Rate |
$142.81 |
| Max. Negotiated Rate |
$990.03 |
| Rate for Payer: Aetna Commercial |
$191.37
|
| Rate for Payer: Aetna Medicare |
$142.81
|
| Rate for Payer: BCBS Complete |
$146.00
|
| Rate for Payer: BCBS MAPPO |
$142.81
|
| Rate for Payer: BCBS Trust/PPO |
$990.03
|
| Rate for Payer: BCN Commercial |
$217.95
|
| Rate for Payer: BCN Medicare Advantage |
$142.81
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cash Price |
$292.00
|
| Rate for Payer: Cofinity Commercial |
$205.65
|
| Rate for Payer: Cofinity Commercial |
$191.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.81
|
| Rate for Payer: Healthscope Commercial |
$171.37
|
| Rate for Payer: Healthscope Whirlpool |
$171.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$149.95
|
| Rate for Payer: PACE SWMI |
$142.81
|
| Rate for Payer: PHP Medicare Advantage |
$142.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$255.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$200.32
|
| Rate for Payer: Priority Health Medicare |
$142.81
|
| Rate for Payer: Priority Health Narrow Network |
$200.32
|
| Rate for Payer: UHC Medicare Advantage |
$147.09
|
|
|
PR NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 95885
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$1,360.37 |
| Rate for Payer: Aetna Commercial |
$78.01
|
| Rate for Payer: Aetna Commercial |
$78.01
|
| Rate for Payer: Aetna Medicare |
$58.22
|
| Rate for Payer: Aetna Medicare |
$58.22
|
| Rate for Payer: BCBS Complete |
$60.40
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCBS MAPPO |
$58.22
|
| Rate for Payer: BCBS MAPPO |
$58.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,360.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,360.37
|
| Rate for Payer: BCN Commercial |
$90.41
|
| Rate for Payer: BCN Commercial |
$90.41
|
| Rate for Payer: BCN Medicare Advantage |
$58.22
|
| Rate for Payer: BCN Medicare Advantage |
$58.22
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cofinity Commercial |
$83.84
|
| Rate for Payer: Cofinity Commercial |
$78.01
|
| Rate for Payer: Cofinity Commercial |
$83.84
|
| Rate for Payer: Cofinity Commercial |
$78.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.22
|
| Rate for Payer: Healthscope Commercial |
$69.86
|
| Rate for Payer: Healthscope Commercial |
$69.86
|
| Rate for Payer: Healthscope Whirlpool |
$69.86
|
| Rate for Payer: Healthscope Whirlpool |
$69.86
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$61.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$61.13
|
| Rate for Payer: PACE SWMI |
$58.22
|
| Rate for Payer: PACE SWMI |
$58.22
|
| Rate for Payer: PHP Medicare Advantage |
$58.22
|
| Rate for Payer: PHP Medicare Advantage |
$58.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.09
|
| Rate for Payer: Priority Health Medicare |
$58.22
|
| Rate for Payer: Priority Health Medicare |
$58.22
|
| Rate for Payer: Priority Health Narrow Network |
$83.09
|
| Rate for Payer: Priority Health Narrow Network |
$83.09
|
| Rate for Payer: UHC Medicare Advantage |
$59.97
|
| Rate for Payer: UHC Medicare Advantage |
$59.97
|
|
|
PR NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 95886
|
| Min. Negotiated Rate |
$92.65 |
| Max. Negotiated Rate |
$1,755.54 |
| Rate for Payer: Aetna Commercial |
$124.15
|
| Rate for Payer: Aetna Commercial |
$124.15
|
| Rate for Payer: Aetna Medicare |
$92.65
|
| Rate for Payer: Aetna Medicare |
$92.65
|
| Rate for Payer: BCBS Complete |
$94.80
|
| Rate for Payer: BCBS Complete |
$66.80
|
| Rate for Payer: BCBS MAPPO |
$92.65
|
| Rate for Payer: BCBS MAPPO |
$92.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,755.54
|
| Rate for Payer: BCBS Trust/PPO |
$1,755.54
|
| Rate for Payer: BCN Commercial |
$142.21
|
| Rate for Payer: BCN Commercial |
$142.21
|
| Rate for Payer: BCN Medicare Advantage |
$92.65
|
| Rate for Payer: BCN Medicare Advantage |
$92.65
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$133.42
|
| Rate for Payer: Cofinity Commercial |
$133.42
|
| Rate for Payer: Cofinity Commercial |
$124.15
|
| Rate for Payer: Cofinity Commercial |
$124.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.65
|
| Rate for Payer: Healthscope Commercial |
$111.18
|
| Rate for Payer: Healthscope Commercial |
$111.18
|
| Rate for Payer: Healthscope Whirlpool |
$111.18
|
| Rate for Payer: Healthscope Whirlpool |
$111.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$97.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$97.28
|
| Rate for Payer: PACE SWMI |
$92.65
|
| Rate for Payer: PACE SWMI |
$92.65
|
| Rate for Payer: PHP Medicare Advantage |
$92.65
|
| Rate for Payer: PHP Medicare Advantage |
$92.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.11
|
| Rate for Payer: Priority Health Medicare |
$92.65
|
| Rate for Payer: Priority Health Medicare |
$92.65
|
| Rate for Payer: Priority Health Narrow Network |
$141.11
|
| Rate for Payer: Priority Health Narrow Network |
$141.11
|
| Rate for Payer: UHC Medicare Advantage |
$95.43
|
| Rate for Payer: UHC Medicare Advantage |
$95.43
|
|
|
PR NEEDLE EMG GUID W/CHEMODENERVATION
|
Professional
|
Both
|
$124.00
|
|
|
Service Code
|
HCPCS 95874
|
| Min. Negotiated Rate |
$49.60 |
| Max. Negotiated Rate |
$1,247.84 |
| Rate for Payer: Aetna Commercial |
$97.12
|
| Rate for Payer: Aetna Medicare |
$72.48
|
| Rate for Payer: BCBS Complete |
$49.60
|
| Rate for Payer: BCBS MAPPO |
$72.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,247.84
|
| Rate for Payer: BCN Commercial |
$112.89
|
| Rate for Payer: BCN Medicare Advantage |
$72.48
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cofinity Commercial |
$104.37
|
| Rate for Payer: Cofinity Commercial |
$97.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.48
|
| Rate for Payer: Healthscope Commercial |
$86.98
|
| Rate for Payer: Healthscope Whirlpool |
$86.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$76.10
|
| Rate for Payer: PACE SWMI |
$72.48
|
| Rate for Payer: PHP Medicare Advantage |
$72.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$103.75
|
| Rate for Payer: Priority Health Medicare |
$72.48
|
| Rate for Payer: Priority Health Narrow Network |
$103.75
|
| Rate for Payer: UHC Medicare Advantage |
$74.65
|
|
|
PR NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 95870
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$288.98 |
| Rate for Payer: Aetna Commercial |
$104.72
|
| Rate for Payer: Aetna Medicare |
$78.15
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: BCBS MAPPO |
$78.15
|
| Rate for Payer: BCBS Trust/PPO |
$288.98
|
| Rate for Payer: BCN Commercial |
$121.68
|
| Rate for Payer: BCN Medicare Advantage |
$78.15
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$112.54
|
| Rate for Payer: Cofinity Commercial |
$104.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.15
|
| Rate for Payer: Healthscope Commercial |
$93.78
|
| Rate for Payer: Healthscope Whirlpool |
$93.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$82.06
|
| Rate for Payer: PACE SWMI |
$78.15
|
| Rate for Payer: PHP Medicare Advantage |
$78.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.84
|
| Rate for Payer: Priority Health Medicare |
$78.15
|
| Rate for Payer: Priority Health Narrow Network |
$111.84
|
| Rate for Payer: UHC Medicare Advantage |
$80.49
|
|
