|
PR DLYD PLACEMENT XTN PROSTH FOR EVASC RPR 1ST VSL
|
Professional
|
Both
|
$1,731.00
|
|
|
Service Code
|
HCPCS 34710
|
| Min. Negotiated Rate |
$460.72 |
| Max. Negotiated Rate |
$1,437.34 |
| Rate for Payer: Aetna Commercial |
$976.12
|
| Rate for Payer: Aetna Medicare |
$728.45
|
| Rate for Payer: BCBS Complete |
$483.76
|
| Rate for Payer: BCBS MAPPO |
$728.45
|
| Rate for Payer: BCN Commercial |
$1,162.29
|
| Rate for Payer: BCN Medicare Advantage |
$728.45
|
| Rate for Payer: Cash Price |
$1,384.80
|
| Rate for Payer: Cash Price |
$1,384.80
|
| Rate for Payer: Cofinity Commercial |
$976.12
|
| Rate for Payer: Cofinity Commercial |
$1,048.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$728.45
|
| Rate for Payer: Healthscope Commercial |
$874.14
|
| Rate for Payer: Healthscope Whirlpool |
$874.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$764.87
|
| Rate for Payer: Meridian Medicaid |
$483.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$801.29
|
| Rate for Payer: Nomi Health Commercial |
$874.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,298.25
|
| Rate for Payer: PACE SWMI |
$728.45
|
| Rate for Payer: PHP Medicare Advantage |
$728.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,249.90
|
| Rate for Payer: Priority Health Medicare |
$728.45
|
| Rate for Payer: Priority Health Narrow Network |
$1,249.90
|
| Rate for Payer: Railroad Medicare Medicare |
$728.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,437.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$728.45
|
| Rate for Payer: UHC Exchange |
$1,437.34
|
| Rate for Payer: UHC Medicaid |
$460.72
|
| Rate for Payer: UHCCP DNSP |
$728.45
|
| Rate for Payer: UHCCP Medicaid |
$460.72
|
|
|
PR DLYD PLACEMENT XTN PROSTH FOR EVASC RPR EA ADDL
|
Professional
|
Both
|
$648.00
|
|
|
Service Code
|
HCPCS 34711
|
| Min. Negotiated Rate |
$168.48 |
| Max. Negotiated Rate |
$538.04 |
| Rate for Payer: Aetna Commercial |
$360.12
|
| Rate for Payer: Aetna Medicare |
$268.75
|
| Rate for Payer: BCBS Complete |
$176.90
|
| Rate for Payer: BCBS MAPPO |
$268.75
|
| Rate for Payer: BCN Commercial |
$428.76
|
| Rate for Payer: BCN Medicare Advantage |
$268.75
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cofinity Commercial |
$387.00
|
| Rate for Payer: Cofinity Commercial |
$360.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.75
|
| Rate for Payer: Healthscope Commercial |
$322.50
|
| Rate for Payer: Healthscope Whirlpool |
$322.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$282.19
|
| Rate for Payer: Meridian Medicaid |
$176.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$295.62
|
| Rate for Payer: Nomi Health Commercial |
$322.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$486.00
|
| Rate for Payer: PACE SWMI |
$268.75
|
| Rate for Payer: PHP Medicare Advantage |
$268.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$461.07
|
| Rate for Payer: Priority Health Medicare |
$268.75
|
| Rate for Payer: Priority Health Narrow Network |
$461.07
|
| Rate for Payer: Railroad Medicare Medicare |
$268.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$538.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$268.75
|
| Rate for Payer: UHC Exchange |
$538.04
|
| Rate for Payer: UHC Medicaid |
$168.48
|
| Rate for Payer: UHCCP DNSP |
$268.75
|
| Rate for Payer: UHCCP Medicaid |
$168.48
|
|
|
PR DLYD PLMT PROX XTN PROSTH NOT COV LSA ORIGIN
|
Professional
|
Both
|
$2,346.00
|
|
|
Service Code
|
HCPCS 33883
|
| Min. Negotiated Rate |
$613.23 |
| Max. Negotiated Rate |
$1,996.35 |
| Rate for Payer: Aetna Commercial |
$1,298.25
|
| Rate for Payer: Aetna Medicare |
$968.84
|
| Rate for Payer: BCBS Complete |
$643.89
|
| Rate for Payer: BCBS MAPPO |
$968.84
|
| Rate for Payer: BCN Commercial |
$1,619.44
|
| Rate for Payer: BCN Medicare Advantage |
$968.84
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cash Price |
$1,876.80
|
| Rate for Payer: Cofinity Commercial |
$1,298.25
|
| Rate for Payer: Cofinity Commercial |
$1,395.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$968.84
|
| Rate for Payer: Healthscope Commercial |
$1,162.61
|
| Rate for Payer: Healthscope Whirlpool |
$1,162.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,017.28
|
| Rate for Payer: Meridian Medicaid |
$643.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,065.72
|
| Rate for Payer: Nomi Health Commercial |
$1,162.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,759.50
|
| Rate for Payer: PACE SWMI |
$968.84
|
| Rate for Payer: PHP Medicare Advantage |
$968.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$613.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,741.50
|
| Rate for Payer: Priority Health Medicare |
$968.84
|
| Rate for Payer: Priority Health Narrow Network |
$1,741.50
|
| Rate for Payer: Railroad Medicare Medicare |
$968.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,996.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$968.84
|
| Rate for Payer: UHC Exchange |
$1,996.35
|
| Rate for Payer: UHC Medicaid |
$613.23
|
| Rate for Payer: UHCCP DNSP |
$968.84
|
| Rate for Payer: UHCCP Medicaid |
$613.23
|
|
|
PR DOG EAR REVISION
|
Professional
|
Both
|
$2,704.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$1,081.60 |
| Max. Negotiated Rate |
$2,028.00 |
| Rate for Payer: BCBS Complete |
$1,081.60
|
| Rate for Payer: Cash Price |
$2,163.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,028.00
|
|
|
PR DOMICIL/REST HOME NEW PT VISIT LOW SEVER 20 MIN
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 99324
|
| Min. Negotiated Rate |
$38.00 |
| Max. Negotiated Rate |
$71.25 |
| Rate for Payer: BCBS Complete |
$38.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.25
|
|
|
PR DOM/R-HOME E/M EST PT LW MOD SEVERITY 25 MINUTES
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 99335
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$110.25 |
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.25
|
|
|
PR DOM/R-HOME E/M EST PT MOD HI SEVERITY 40 MINUTES
|
Professional
|
Both
|
$208.00
|
|
|
Service Code
|
HCPCS 99336
|
| Min. Negotiated Rate |
$83.20 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: BCBS Complete |
$83.20
|
| Rate for Payer: Cash Price |
$166.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.00
|
|
|
PR DOM/R-HOME E/M EST PT SELF-LMTD/MINOR 15 MINUTES
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 99334
|
| Min. Negotiated Rate |
$37.60 |
| Max. Negotiated Rate |
$70.50 |
| Rate for Payer: BCBS Complete |
$37.60
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.50
|
|
|
PR DOM/R-HOME E/M EST PT SIGNIF NEW PROB 60 MINUTES
|
Professional
|
Both
|
$298.00
|
|
|
Service Code
|
HCPCS 99337
|
| Min. Negotiated Rate |
$119.20 |
| Max. Negotiated Rate |
$223.50 |
| Rate for Payer: BCBS Complete |
$119.20
|
| Rate for Payer: Cash Price |
$238.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.50
|
|
|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Professional
|
Both
|
$340.00
|
|
|
Service Code
|
HCPCS 93325
|
| Min. Negotiated Rate |
$21.85 |
| Max. Negotiated Rate |
$255.00 |
| Rate for Payer: Aetna Commercial |
$29.28
|
| Rate for Payer: Aetna Commercial |
$29.28
|
| Rate for Payer: Aetna Medicare |
$21.85
|
| Rate for Payer: Aetna Medicare |
$21.85
|
| Rate for Payer: BCBS MAPPO |
$21.85
|
| Rate for Payer: BCBS MAPPO |
$21.85
|
| Rate for Payer: BCN Commercial |
$33.87
|
| Rate for Payer: BCN Commercial |
$33.87
|
| Rate for Payer: BCN Medicare Advantage |
$21.85
|
| Rate for Payer: BCN Medicare Advantage |
$21.85
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cofinity Commercial |
$31.46
|
| Rate for Payer: Cofinity Commercial |
$29.28
|
| Rate for Payer: Cofinity Commercial |
$31.46
|
| Rate for Payer: Cofinity Commercial |
$29.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.85
|
| Rate for Payer: Healthscope Commercial |
$26.22
|
| Rate for Payer: Healthscope Commercial |
$26.22
|
| Rate for Payer: Healthscope Whirlpool |
$26.22
|
| Rate for Payer: Healthscope Whirlpool |
$26.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.04
|
| Rate for Payer: Nomi Health Commercial |
$26.22
|
| Rate for Payer: Nomi Health Commercial |
$26.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$255.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$155.25
|
| Rate for Payer: PACE SWMI |
$21.85
|
| Rate for Payer: PACE SWMI |
$21.85
|
| Rate for Payer: PHP Medicare Advantage |
$21.85
|
| Rate for Payer: PHP Medicare Advantage |
$21.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$32.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$32.19
|
| Rate for Payer: Priority Health Medicare |
$21.85
|
| Rate for Payer: Priority Health Medicare |
$21.85
|
| Rate for Payer: Priority Health Narrow Network |
$32.19
|
| Rate for Payer: Priority Health Narrow Network |
$32.19
|
| Rate for Payer: Railroad Medicare Medicare |
$21.85
|
| Rate for Payer: Railroad Medicare Medicare |
$21.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.85
|
| Rate for Payer: UHC Exchange |
$37.56
|
| Rate for Payer: UHC Exchange |
$37.56
|
| Rate for Payer: UHCCP DNSP |
$21.85
|
| Rate for Payer: UHCCP DNSP |
$21.85
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 93320
|
| Min. Negotiated Rate |
$48.18 |
| Max. Negotiated Rate |
$135.75 |
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: Aetna Medicare |
$48.18
|
| Rate for Payer: Aetna Medicare |
$48.18
|
| Rate for Payer: BCBS MAPPO |
$48.18
|
| Rate for Payer: BCBS MAPPO |
$48.18
|
| Rate for Payer: BCN Commercial |
$74.70
|
| Rate for Payer: BCN Commercial |
$74.70
|
| Rate for Payer: BCN Medicare Advantage |
$48.18
|
| Rate for Payer: BCN Medicare Advantage |
$48.18
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cofinity Commercial |
$64.56
|
| Rate for Payer: Cofinity Commercial |
$69.38
|
| Rate for Payer: Cofinity Commercial |
$64.56
|
| Rate for Payer: Cofinity Commercial |
$69.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.18
|
| Rate for Payer: Healthscope Commercial |
$57.82
|
| Rate for Payer: Healthscope Commercial |
$57.82
|
| Rate for Payer: Healthscope Whirlpool |
$57.82
|
| Rate for Payer: Healthscope Whirlpool |
$57.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.00
|
| Rate for Payer: Nomi Health Commercial |
$57.82
|
| Rate for Payer: Nomi Health Commercial |
$57.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$200.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.75
|
| Rate for Payer: PACE SWMI |
$48.18
|
| Rate for Payer: PACE SWMI |
$48.18
|
| Rate for Payer: PHP Medicare Advantage |
$48.18
|
| Rate for Payer: PHP Medicare Advantage |
$48.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$71.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$71.00
|
| Rate for Payer: Priority Health Medicare |
$48.18
|
| Rate for Payer: Priority Health Medicare |
$48.18
|
| Rate for Payer: Priority Health Narrow Network |
$71.00
|
| Rate for Payer: Priority Health Narrow Network |
$71.00
|
| Rate for Payer: Railroad Medicare Medicare |
$48.18
|
| Rate for Payer: Railroad Medicare Medicare |
$48.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.18
|
| Rate for Payer: UHC Exchange |
$82.25
|
| Rate for Payer: UHC Exchange |
$82.25
|
| Rate for Payer: UHCCP DNSP |
$48.18
|
| Rate for Payer: UHCCP DNSP |
$48.18
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL F-UP/LMTD STD
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 93321
|
| Min. Negotiated Rate |
$23.68 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: Aetna Commercial |
$31.73
|
| Rate for Payer: Aetna Medicare |
$23.68
|
| Rate for Payer: BCBS MAPPO |
$23.68
|
| Rate for Payer: BCN Commercial |
$36.85
|
| Rate for Payer: BCN Medicare Advantage |
$23.68
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$31.73
|
| Rate for Payer: Cofinity Commercial |
$34.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.68
|
| Rate for Payer: Healthscope Commercial |
$28.42
|
| Rate for Payer: Healthscope Whirlpool |
$28.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.05
|
| Rate for Payer: Nomi Health Commercial |
$28.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.00
|
| Rate for Payer: PACE SWMI |
$23.68
|
| Rate for Payer: PHP Medicare Advantage |
$23.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$35.03
|
| Rate for Payer: Priority Health Medicare |
$23.68
|
| Rate for Payer: Priority Health Narrow Network |
$35.03
|
| Rate for Payer: Railroad Medicare Medicare |
$23.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.68
|
| Rate for Payer: UHC Exchange |
$40.67
|
| Rate for Payer: UHCCP DNSP |
$23.68
|
|
|
PR DRAIN ABD ABSCESS PERCUTANEOUS
|
Professional
|
Both
|
$638.00
|
|
|
Service Code
|
HCPCS 49021
|
| Min. Negotiated Rate |
$255.20 |
| Max. Negotiated Rate |
$478.50 |
| Rate for Payer: BCBS Complete |
$255.20
|
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$478.50
|
|
|
PR DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH
|
Professional
|
Both
|
$385.00
|
|
|
Service Code
|
HCPCS 30000
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$288.75 |
| Rate for Payer: Aetna Commercial |
$142.90
|
| Rate for Payer: Aetna Medicare |
$106.64
|
| Rate for Payer: BCBS Complete |
$74.03
|
| Rate for Payer: BCBS MAPPO |
$106.64
|
| Rate for Payer: BCN Commercial |
$184.75
|
| Rate for Payer: BCN Medicare Advantage |
$106.64
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Cofinity Commercial |
$153.56
|
| Rate for Payer: Cofinity Commercial |
$142.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.64
|
| Rate for Payer: Healthscope Commercial |
$127.97
|
| Rate for Payer: Healthscope Whirlpool |
$127.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.97
|
| Rate for Payer: Meridian Medicaid |
$74.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$117.30
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$288.75
|
| Rate for Payer: PACE SWMI |
$106.64
|
| Rate for Payer: PHP Medicare Advantage |
$106.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$173.99
|
| Rate for Payer: Priority Health Medicare |
$106.64
|
| Rate for Payer: Priority Health Narrow Network |
$173.99
|
| Rate for Payer: Railroad Medicare Medicare |
$106.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$106.64
|
| Rate for Payer: UHC Exchange |
$203.27
|
| Rate for Payer: UHC Medicaid |
$70.50
|
| Rate for Payer: UHCCP DNSP |
$106.64
|
| Rate for Payer: UHCCP Medicaid |
$70.50
|
|
|
PR DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM
|
Professional
|
Both
|
$313.00
|
|
|
Service Code
|
HCPCS 30020
|
| Min. Negotiated Rate |
$71.14 |
| Max. Negotiated Rate |
$234.75 |
| Rate for Payer: Aetna Commercial |
$144.12
|
| Rate for Payer: Aetna Medicare |
$107.55
|
| Rate for Payer: BCBS Complete |
$74.70
|
| Rate for Payer: BCBS MAPPO |
$107.55
|
| Rate for Payer: BCN Commercial |
$185.25
|
| Rate for Payer: BCN Medicare Advantage |
$107.55
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cash Price |
$250.40
|
| Rate for Payer: Cofinity Commercial |
$154.87
|
| Rate for Payer: Cofinity Commercial |
$144.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.55
|
| Rate for Payer: Healthscope Commercial |
$129.06
|
| Rate for Payer: Healthscope Whirlpool |
$129.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.93
|
| Rate for Payer: Meridian Medicaid |
$74.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$118.31
|
| Rate for Payer: Nomi Health Commercial |
$129.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.75
|
| Rate for Payer: PACE SWMI |
$107.55
|
| Rate for Payer: PHP Medicare Advantage |
$107.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$174.45
|
| Rate for Payer: Priority Health Medicare |
$107.55
|
| Rate for Payer: Priority Health Narrow Network |
$174.45
|
| Rate for Payer: Railroad Medicare Medicare |
$107.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$204.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.55
|
| Rate for Payer: UHC Exchange |
$204.42
|
| Rate for Payer: UHC Medicaid |
$71.14
|
| Rate for Payer: UHCCP DNSP |
$107.55
|
| Rate for Payer: UHCCP Medicaid |
$71.14
|
|
|
PR DRAINAGE ABSCESS PALATE UVULA
|
Professional
|
Both
|
$346.00
|
|
|
Service Code
|
HCPCS 42000
|
| Min. Negotiated Rate |
$63.26 |
| Max. Negotiated Rate |
$259.50 |
| Rate for Payer: Aetna Commercial |
$127.97
|
| Rate for Payer: Aetna Medicare |
$95.50
|
| Rate for Payer: BCBS Complete |
$66.42
|
| Rate for Payer: BCBS MAPPO |
$95.50
|
| Rate for Payer: BCN Commercial |
$165.33
|
| Rate for Payer: BCN Medicare Advantage |
$95.50
|
| Rate for Payer: Cash Price |
$276.80
|
| Rate for Payer: Cash Price |
$276.80
|
| Rate for Payer: Cofinity Commercial |
$137.52
|
| Rate for Payer: Cofinity Commercial |
$127.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.50
|
| Rate for Payer: Healthscope Commercial |
$114.60
|
| Rate for Payer: Healthscope Whirlpool |
$114.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.28
|
| Rate for Payer: Meridian Medicaid |
$66.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.05
|
| Rate for Payer: Nomi Health Commercial |
$114.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.50
|
| Rate for Payer: PACE SWMI |
$95.50
|
| Rate for Payer: PHP Medicare Advantage |
$95.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$201.44
|
| Rate for Payer: Priority Health Medicare |
$95.50
|
| Rate for Payer: Priority Health Narrow Network |
$201.44
|
| Rate for Payer: Railroad Medicare Medicare |
$95.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$95.50
|
| Rate for Payer: UHC Exchange |
$179.01
|
| Rate for Payer: UHC Medicaid |
$63.26
|
| Rate for Payer: UHCCP DNSP |
$95.50
|
| Rate for Payer: UHCCP Medicaid |
$63.26
|
|
|
PR DRAINAGE ABSCESS PAROTID COMPLICATED
|
Professional
|
Both
|
$806.00
|
|
|
Service Code
|
HCPCS 42305
|
| Min. Negotiated Rate |
$245.38 |
| Max. Negotiated Rate |
$798.49 |
| Rate for Payer: Aetna Commercial |
$503.40
|
| Rate for Payer: Aetna Medicare |
$375.67
|
| Rate for Payer: BCBS Complete |
$257.65
|
| Rate for Payer: BCBS MAPPO |
$375.67
|
| Rate for Payer: BCN Commercial |
$655.34
|
| Rate for Payer: BCN Medicare Advantage |
$375.67
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cash Price |
$644.80
|
| Rate for Payer: Cofinity Commercial |
$540.96
|
| Rate for Payer: Cofinity Commercial |
$503.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$375.67
|
| Rate for Payer: Healthscope Commercial |
$450.80
|
| Rate for Payer: Healthscope Whirlpool |
$450.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$394.45
|
| Rate for Payer: Meridian Medicaid |
$257.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$413.24
|
| Rate for Payer: Nomi Health Commercial |
$450.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$604.50
|
| Rate for Payer: PACE SWMI |
$375.67
|
| Rate for Payer: PHP Medicare Advantage |
$375.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$245.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$798.49
|
| Rate for Payer: Priority Health Medicare |
$375.67
|
| Rate for Payer: Priority Health Narrow Network |
$798.49
|
| Rate for Payer: Railroad Medicare Medicare |
$375.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$742.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$375.67
|
| Rate for Payer: UHC Exchange |
$742.02
|
| Rate for Payer: UHC Medicaid |
$245.38
|
| Rate for Payer: UHCCP DNSP |
$375.67
|
| Rate for Payer: UHCCP Medicaid |
$245.38
|
|
|
PR DRAINAGE ABSCESS PAROTID SIMPLE
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 42300
|
| Min. Negotiated Rate |
$90.31 |
| Max. Negotiated Rate |
$288.22 |
| Rate for Payer: Aetna Commercial |
$183.29
|
| Rate for Payer: Aetna Medicare |
$136.78
|
| Rate for Payer: BCBS Complete |
$94.83
|
| Rate for Payer: BCBS MAPPO |
$136.78
|
| Rate for Payer: BCN Commercial |
$236.55
|
| Rate for Payer: BCN Medicare Advantage |
$136.78
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$196.96
|
| Rate for Payer: Cofinity Commercial |
$183.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.78
|
| Rate for Payer: Healthscope Commercial |
$164.14
|
| Rate for Payer: Healthscope Whirlpool |
$164.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.62
|
| Rate for Payer: Meridian Medicaid |
$94.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.46
|
| Rate for Payer: Nomi Health Commercial |
$164.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.25
|
| Rate for Payer: PACE SWMI |
$136.78
|
| Rate for Payer: PHP Medicare Advantage |
$136.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$288.22
|
| Rate for Payer: Priority Health Medicare |
$136.78
|
| Rate for Payer: Priority Health Narrow Network |
$288.22
|
| Rate for Payer: Railroad Medicare Medicare |
$136.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$264.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$136.78
|
| Rate for Payer: UHC Exchange |
$264.29
|
| Rate for Payer: UHC Medicaid |
$90.31
|
| Rate for Payer: UHCCP DNSP |
$136.78
|
| Rate for Payer: UHCCP Medicaid |
$90.31
|
|
|
PR DRAINAGE DEEP PERIURETHRAL ABSCESS
|
Professional
|
Both
|
$839.00
|
|
|
Service Code
|
HCPCS 53040
|
| Min. Negotiated Rate |
$231.11 |
| Max. Negotiated Rate |
$689.41 |
| Rate for Payer: Aetna Commercial |
$476.18
|
| Rate for Payer: Aetna Medicare |
$355.36
|
| Rate for Payer: BCBS Complete |
$242.67
|
| Rate for Payer: BCBS MAPPO |
$355.36
|
| Rate for Payer: BCN Commercial |
$592.10
|
| Rate for Payer: BCN Medicare Advantage |
$355.36
|
| Rate for Payer: Cash Price |
$671.20
|
| Rate for Payer: Cash Price |
$671.20
|
| Rate for Payer: Cofinity Commercial |
$511.72
|
| Rate for Payer: Cofinity Commercial |
$476.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$355.36
|
| Rate for Payer: Healthscope Commercial |
$426.43
|
| Rate for Payer: Healthscope Whirlpool |
$426.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$373.13
|
| Rate for Payer: Meridian Medicaid |
$242.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$390.90
|
| Rate for Payer: Nomi Health Commercial |
$426.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$629.25
|
| Rate for Payer: PACE SWMI |
$355.36
|
| Rate for Payer: PHP Medicare Advantage |
$355.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$231.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$644.99
|
| Rate for Payer: Priority Health Medicare |
$355.36
|
| Rate for Payer: Priority Health Narrow Network |
$644.99
|
| Rate for Payer: Railroad Medicare Medicare |
$355.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$689.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$355.36
|
| Rate for Payer: UHC Exchange |
$689.41
|
| Rate for Payer: UHC Medicaid |
$231.11
|
| Rate for Payer: UHCCP DNSP |
$355.36
|
| Rate for Payer: UHCCP Medicaid |
$231.11
|
|
|
PR DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS
|
Professional
|
Both
|
$391.00
|
|
|
Service Code
|
HCPCS 69020
|
| Min. Negotiated Rate |
$84.77 |
| Max. Negotiated Rate |
$293.25 |
| Rate for Payer: Aetna Commercial |
$170.47
|
| Rate for Payer: Aetna Medicare |
$127.22
|
| Rate for Payer: BCBS Complete |
$89.01
|
| Rate for Payer: BCBS MAPPO |
$127.22
|
| Rate for Payer: BCN Commercial |
$216.62
|
| Rate for Payer: BCN Medicare Advantage |
$127.22
|
| Rate for Payer: Cash Price |
$312.80
|
| Rate for Payer: Cash Price |
$312.80
|
| Rate for Payer: Cofinity Commercial |
$183.20
|
| Rate for Payer: Cofinity Commercial |
$170.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.22
|
| Rate for Payer: Healthscope Commercial |
$152.66
|
| Rate for Payer: Healthscope Whirlpool |
$152.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.58
|
| Rate for Payer: Meridian Medicaid |
$89.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.94
|
| Rate for Payer: Nomi Health Commercial |
$152.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$293.25
|
| Rate for Payer: PACE SWMI |
$127.22
|
| Rate for Payer: PHP Medicare Advantage |
$127.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$214.05
|
| Rate for Payer: Priority Health Medicare |
$127.22
|
| Rate for Payer: Priority Health Narrow Network |
$214.05
|
| Rate for Payer: Railroad Medicare Medicare |
$127.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$239.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$127.22
|
| Rate for Payer: UHC Exchange |
$239.74
|
| Rate for Payer: UHC Medicaid |
$84.77
|
| Rate for Payer: UHCCP DNSP |
$127.22
|
| Rate for Payer: UHCCP Medicaid |
$84.77
|
|
|
PR DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA COMP
|
Professional
|
Both
|
$397.00
|
|
|
Service Code
|
HCPCS 69005
|
| Min. Negotiated Rate |
$93.29 |
| Max. Negotiated Rate |
$297.75 |
| Rate for Payer: Aetna Commercial |
$190.39
|
| Rate for Payer: Aetna Medicare |
$142.08
|
| Rate for Payer: BCBS Complete |
$97.95
|
| Rate for Payer: BCBS MAPPO |
$142.08
|
| Rate for Payer: BCN Commercial |
$244.01
|
| Rate for Payer: BCN Medicare Advantage |
$142.08
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cofinity Commercial |
$204.60
|
| Rate for Payer: Cofinity Commercial |
$190.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.08
|
| Rate for Payer: Healthscope Commercial |
$170.50
|
| Rate for Payer: Healthscope Whirlpool |
$170.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.18
|
| Rate for Payer: Meridian Medicaid |
$97.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$156.29
|
| Rate for Payer: Nomi Health Commercial |
$170.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.75
|
| Rate for Payer: PACE SWMI |
$142.08
|
| Rate for Payer: PHP Medicare Advantage |
$142.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$241.11
|
| Rate for Payer: Priority Health Medicare |
$142.08
|
| Rate for Payer: Priority Health Narrow Network |
$241.11
|
| Rate for Payer: Railroad Medicare Medicare |
$142.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$271.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$142.08
|
| Rate for Payer: UHC Exchange |
$271.72
|
| Rate for Payer: UHC Medicaid |
$93.29
|
| Rate for Payer: UHCCP DNSP |
$142.08
|
| Rate for Payer: UHCCP Medicaid |
$93.29
|
|
|
PR DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 69000
|
| Min. Negotiated Rate |
$74.98 |
| Max. Negotiated Rate |
$245.25 |
| Rate for Payer: Aetna Commercial |
$151.74
|
| Rate for Payer: Aetna Medicare |
$113.24
|
| Rate for Payer: BCBS Complete |
$78.73
|
| Rate for Payer: BCBS MAPPO |
$113.24
|
| Rate for Payer: BCN Commercial |
$189.23
|
| Rate for Payer: BCN Medicare Advantage |
$113.24
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$163.07
|
| Rate for Payer: Cofinity Commercial |
$151.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.24
|
| Rate for Payer: Healthscope Commercial |
$135.89
|
| Rate for Payer: Healthscope Whirlpool |
$135.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.90
|
| Rate for Payer: Meridian Medicaid |
$78.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$124.56
|
| Rate for Payer: Nomi Health Commercial |
$135.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$245.25
|
| Rate for Payer: PACE SWMI |
$113.24
|
| Rate for Payer: PHP Medicare Advantage |
$113.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$186.99
|
| Rate for Payer: Priority Health Medicare |
$113.24
|
| Rate for Payer: Priority Health Narrow Network |
$186.99
|
| Rate for Payer: Railroad Medicare Medicare |
$113.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$208.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$113.24
|
| Rate for Payer: UHC Exchange |
$208.59
|
| Rate for Payer: UHC Medicaid |
$74.98
|
| Rate for Payer: UHCCP DNSP |
$113.24
|
| Rate for Payer: UHCCP Medicaid |
$74.98
|
|
|
PR DRAINAGE FINGER ABSCESS COMPLICATED
|
Professional
|
Both
|
$835.00
|
|
|
Service Code
|
HCPCS 26011
|
| Min. Negotiated Rate |
$116.30 |
| Max. Negotiated Rate |
$626.25 |
| Rate for Payer: Aetna Commercial |
$235.76
|
| Rate for Payer: Aetna Medicare |
$175.94
|
| Rate for Payer: BCBS Complete |
$122.11
|
| Rate for Payer: BCBS MAPPO |
$175.94
|
| Rate for Payer: BCN Commercial |
$282.86
|
| Rate for Payer: BCN Medicare Advantage |
$175.94
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Cash Price |
$668.00
|
| Rate for Payer: Cofinity Commercial |
$253.35
|
| Rate for Payer: Cofinity Commercial |
$235.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.94
|
| Rate for Payer: Healthscope Commercial |
$211.13
|
| Rate for Payer: Healthscope Whirlpool |
$211.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.74
|
| Rate for Payer: Meridian Medicaid |
$122.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$193.53
|
| Rate for Payer: Nomi Health Commercial |
$211.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$626.25
|
| Rate for Payer: PACE SWMI |
$175.94
|
| Rate for Payer: PHP Medicare Advantage |
$175.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$116.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$302.37
|
| Rate for Payer: Priority Health Medicare |
$175.94
|
| Rate for Payer: Priority Health Narrow Network |
$302.37
|
| Rate for Payer: Railroad Medicare Medicare |
$175.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$319.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$175.94
|
| Rate for Payer: UHC Exchange |
$319.79
|
| Rate for Payer: UHC Medicaid |
$116.30
|
| Rate for Payer: UHCCP DNSP |
$175.94
|
| Rate for Payer: UHCCP Medicaid |
$116.30
|
|
|
PR DRAINAGE FINGER ABSCESS SIMPLE
|
Professional
|
Both
|
$593.00
|
|
|
Service Code
|
HCPCS 26010
|
| Min. Negotiated Rate |
$92.44 |
| Max. Negotiated Rate |
$444.75 |
| Rate for Payer: Aetna Commercial |
$186.09
|
| Rate for Payer: Aetna Medicare |
$138.87
|
| Rate for Payer: BCBS Complete |
$97.06
|
| Rate for Payer: BCBS MAPPO |
$138.87
|
| Rate for Payer: BCN Commercial |
$214.63
|
| Rate for Payer: BCN Medicare Advantage |
$138.87
|
| Rate for Payer: Cash Price |
$474.40
|
| Rate for Payer: Cash Price |
$474.40
|
| Rate for Payer: Cofinity Commercial |
$199.97
|
| Rate for Payer: Cofinity Commercial |
$186.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.87
|
| Rate for Payer: Healthscope Commercial |
$166.64
|
| Rate for Payer: Healthscope Whirlpool |
$166.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.81
|
| Rate for Payer: Meridian Medicaid |
$97.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$152.76
|
| Rate for Payer: Nomi Health Commercial |
$166.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$444.75
|
| Rate for Payer: PACE SWMI |
$138.87
|
| Rate for Payer: PHP Medicare Advantage |
$138.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$229.43
|
| Rate for Payer: Priority Health Medicare |
$138.87
|
| Rate for Payer: Priority Health Narrow Network |
$229.43
|
| Rate for Payer: Railroad Medicare Medicare |
$138.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$238.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$138.87
|
| Rate for Payer: UHC Exchange |
$238.01
|
| Rate for Payer: UHC Medicaid |
$92.44
|
| Rate for Payer: UHCCP DNSP |
$138.87
|
| Rate for Payer: UHCCP Medicaid |
$92.44
|
|
|
PR DRAINAGE OF PALMAR BURSA MULTIPLE BURSA
|
Professional
|
Both
|
$3,273.00
|
|
|
Service Code
|
HCPCS 26030
|
| Min. Negotiated Rate |
$297.14 |
| Max. Negotiated Rate |
$2,454.75 |
| Rate for Payer: Aetna Commercial |
$605.26
|
| Rate for Payer: Aetna Medicare |
$451.69
|
| Rate for Payer: BCBS Complete |
$312.00
|
| Rate for Payer: BCBS MAPPO |
$451.69
|
| Rate for Payer: BCN Commercial |
$756.93
|
| Rate for Payer: BCN Medicare Advantage |
$451.69
|
| Rate for Payer: Cash Price |
$2,618.40
|
| Rate for Payer: Cash Price |
$2,618.40
|
| Rate for Payer: Cofinity Commercial |
$650.43
|
| Rate for Payer: Cofinity Commercial |
$605.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$451.69
|
| Rate for Payer: Healthscope Commercial |
$542.03
|
| Rate for Payer: Healthscope Whirlpool |
$542.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$474.27
|
| Rate for Payer: Meridian Medicaid |
$312.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$496.86
|
| Rate for Payer: Nomi Health Commercial |
$542.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,454.75
|
| Rate for Payer: PACE SWMI |
$451.69
|
| Rate for Payer: PHP Medicare Advantage |
$451.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$297.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$809.14
|
| Rate for Payer: Priority Health Medicare |
$451.69
|
| Rate for Payer: Priority Health Narrow Network |
$809.14
|
| Rate for Payer: Railroad Medicare Medicare |
$451.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$852.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$451.69
|
| Rate for Payer: UHC Exchange |
$852.57
|
| Rate for Payer: UHC Medicaid |
$297.14
|
| Rate for Payer: UHCCP DNSP |
$451.69
|
| Rate for Payer: UHCCP Medicaid |
$297.14
|
|
