|
PR DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD
|
Professional
|
Both
|
$86.00
|
|
|
Service Code
|
HCPCS 92587
|
| Min. Negotiated Rate |
$20.33 |
| Max. Negotiated Rate |
$55.90 |
| Rate for Payer: Aetna Commercial |
$27.24
|
| Rate for Payer: Aetna Medicare |
$20.33
|
| Rate for Payer: BCBS Complete |
$34.40
|
| Rate for Payer: BCBS MAPPO |
$20.33
|
| Rate for Payer: BCN Medicare Advantage |
$20.33
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cofinity Commercial |
$29.28
|
| Rate for Payer: Cofinity Commercial |
$27.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.33
|
| Rate for Payer: Healthscope Commercial |
$24.40
|
| Rate for Payer: Healthscope Whirlpool |
$24.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.35
|
| Rate for Payer: Nomi Health Commercial |
$24.40
|
| Rate for Payer: PACE SWMI |
$20.33
|
| Rate for Payer: PHP Medicare Advantage |
$20.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.90
|
| Rate for Payer: Priority Health Medicare |
$20.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.33
|
| Rate for Payer: UHC Medicare Advantage |
$20.33
|
| Rate for Payer: UHCCP DNSP |
$20.33
|
|
|
PR DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
HCPCS 92588
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$44.96 |
| Rate for Payer: Aetna Commercial |
$41.83
|
| Rate for Payer: Aetna Medicare |
$31.22
|
| Rate for Payer: BCBS Complete |
$27.60
|
| Rate for Payer: BCBS MAPPO |
$31.22
|
| Rate for Payer: BCN Medicare Advantage |
$31.22
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$44.96
|
| Rate for Payer: Cofinity Commercial |
$41.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.22
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Healthscope Whirlpool |
$37.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.78
|
| Rate for Payer: Nomi Health Commercial |
$37.46
|
| Rate for Payer: PACE SWMI |
$31.22
|
| Rate for Payer: PHP Medicare Advantage |
$31.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.85
|
| Rate for Payer: Priority Health Medicare |
$31.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.22
|
| Rate for Payer: UHC Medicare Advantage |
$31.22
|
| Rate for Payer: UHCCP DNSP |
$31.22
|
|
|
PR DIVERTICULECTOMY HYPOPHARYNX/ESOPH CRV APPR
|
Professional
|
Both
|
$2,437.00
|
|
|
Service Code
|
HCPCS 43130
|
| Min. Negotiated Rate |
$760.89 |
| Max. Negotiated Rate |
$1,584.05 |
| Rate for Payer: Aetna Commercial |
$1,019.59
|
| Rate for Payer: Aetna Medicare |
$760.89
|
| Rate for Payer: BCBS Complete |
$974.80
|
| Rate for Payer: BCBS MAPPO |
$760.89
|
| Rate for Payer: BCN Medicare Advantage |
$760.89
|
| Rate for Payer: Cash Price |
$1,949.60
|
| Rate for Payer: Cash Price |
$1,949.60
|
| Rate for Payer: Cofinity Commercial |
$1,095.68
|
| Rate for Payer: Cofinity Commercial |
$1,019.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$760.89
|
| Rate for Payer: Healthscope Commercial |
$913.07
|
| Rate for Payer: Healthscope Whirlpool |
$913.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$798.93
|
| Rate for Payer: Nomi Health Commercial |
$913.07
|
| Rate for Payer: PACE SWMI |
$760.89
|
| Rate for Payer: PHP Medicare Advantage |
$760.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,584.05
|
| Rate for Payer: Priority Health Medicare |
$760.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$760.89
|
| Rate for Payer: UHC Medicare Advantage |
$760.89
|
| Rate for Payer: UHCCP DNSP |
$760.89
|
|
|
PR DIVERTICULECTOMY HYPOPHARYNX/ESOPH THRC APPR
|
Professional
|
Both
|
$3,167.00
|
|
|
Service Code
|
HCPCS 43135
|
| Min. Negotiated Rate |
$1,266.80 |
| Max. Negotiated Rate |
$2,058.55 |
| Rate for Payer: Aetna Commercial |
$1,896.94
|
| Rate for Payer: Aetna Medicare |
$1,415.63
|
| Rate for Payer: BCBS Complete |
$1,266.80
|
| Rate for Payer: BCBS MAPPO |
$1,415.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,415.63
|
| Rate for Payer: Cash Price |
$2,533.60
|
| Rate for Payer: Cash Price |
$2,533.60
|
| Rate for Payer: Cofinity Commercial |
$2,038.51
|
| Rate for Payer: Cofinity Commercial |
$1,896.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,415.63
|
| Rate for Payer: Healthscope Commercial |
$1,698.76
|
| Rate for Payer: Healthscope Whirlpool |
$1,698.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,486.41
|
| Rate for Payer: Nomi Health Commercial |
$1,698.76
|
| Rate for Payer: PACE SWMI |
$1,415.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,415.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,058.55
|
| Rate for Payer: Priority Health Medicare |
$1,415.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,415.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,415.63
|
| Rate for Payer: UHCCP DNSP |
$1,415.63
|
|
|
PR DIVISION ABERRANT VESSEL VASCULAR RING
|
Professional
|
Both
|
$4,233.00
|
|
|
Service Code
|
HCPCS 33802
|
| Min. Negotiated Rate |
$1,045.18 |
| Max. Negotiated Rate |
$2,751.45 |
| Rate for Payer: Aetna Commercial |
$1,400.54
|
| Rate for Payer: Aetna Medicare |
$1,045.18
|
| Rate for Payer: BCBS Complete |
$1,693.20
|
| Rate for Payer: BCBS MAPPO |
$1,045.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,045.18
|
| Rate for Payer: Cash Price |
$3,386.40
|
| Rate for Payer: Cash Price |
$3,386.40
|
| Rate for Payer: Cofinity Commercial |
$1,505.06
|
| Rate for Payer: Cofinity Commercial |
$1,400.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,045.18
|
| Rate for Payer: Healthscope Commercial |
$1,254.22
|
| Rate for Payer: Healthscope Whirlpool |
$1,254.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,097.44
|
| Rate for Payer: Nomi Health Commercial |
$1,254.22
|
| Rate for Payer: PACE SWMI |
$1,045.18
|
| Rate for Payer: PHP Medicare Advantage |
$1,045.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,751.45
|
| Rate for Payer: Priority Health Medicare |
$1,045.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,045.18
|
| Rate for Payer: UHC Medicare Advantage |
$1,045.18
|
| Rate for Payer: UHCCP DNSP |
$1,045.18
|
|
|
PR DIVISION PLANTAR FASCIA & MUSCLE SPX
|
Professional
|
Both
|
$1,311.00
|
|
|
Service Code
|
HCPCS 28250
|
| Min. Negotiated Rate |
$397.33 |
| Max. Negotiated Rate |
$852.15 |
| Rate for Payer: Aetna Commercial |
$532.42
|
| Rate for Payer: Aetna Medicare |
$397.33
|
| Rate for Payer: BCBS Complete |
$524.40
|
| Rate for Payer: BCBS MAPPO |
$397.33
|
| Rate for Payer: BCN Medicare Advantage |
$397.33
|
| Rate for Payer: Cash Price |
$1,048.80
|
| Rate for Payer: Cash Price |
$1,048.80
|
| Rate for Payer: Cofinity Commercial |
$572.16
|
| Rate for Payer: Cofinity Commercial |
$532.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$397.33
|
| Rate for Payer: Healthscope Commercial |
$476.80
|
| Rate for Payer: Healthscope Whirlpool |
$476.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$417.20
|
| Rate for Payer: Nomi Health Commercial |
$476.80
|
| Rate for Payer: PACE SWMI |
$397.33
|
| Rate for Payer: PHP Medicare Advantage |
$397.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$852.15
|
| Rate for Payer: Priority Health Medicare |
$397.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$397.33
|
| Rate for Payer: UHC Medicare Advantage |
$397.33
|
| Rate for Payer: UHCCP DNSP |
$397.33
|
|
|
PR DIVISION SCALENUS ANTICUS RESECTION CERVICAL RIB
|
Professional
|
Both
|
$1,119.00
|
|
|
Service Code
|
HCPCS 21705
|
| Min. Negotiated Rate |
$447.60 |
| Max. Negotiated Rate |
$746.02 |
| Rate for Payer: Aetna Commercial |
$694.21
|
| Rate for Payer: Aetna Medicare |
$518.07
|
| Rate for Payer: BCBS Complete |
$447.60
|
| Rate for Payer: BCBS MAPPO |
$518.07
|
| Rate for Payer: BCN Medicare Advantage |
$518.07
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cofinity Commercial |
$746.02
|
| Rate for Payer: Cofinity Commercial |
$694.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$518.07
|
| Rate for Payer: Healthscope Commercial |
$621.68
|
| Rate for Payer: Healthscope Whirlpool |
$621.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.97
|
| Rate for Payer: Nomi Health Commercial |
$621.68
|
| Rate for Payer: PACE SWMI |
$518.07
|
| Rate for Payer: PHP Medicare Advantage |
$518.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$727.35
|
| Rate for Payer: Priority Health Medicare |
$518.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$518.07
|
| Rate for Payer: UHC Medicare Advantage |
$518.07
|
| Rate for Payer: UHCCP DNSP |
$518.07
|
|
|
PR DIVISION SCALENUS ANTICUS W/O RESCJ CERVICAL RIB
|
Professional
|
Both
|
$1,549.00
|
|
|
Service Code
|
HCPCS 21700
|
| Min. Negotiated Rate |
$345.81 |
| Max. Negotiated Rate |
$1,006.85 |
| Rate for Payer: Aetna Commercial |
$463.39
|
| Rate for Payer: Aetna Medicare |
$345.81
|
| Rate for Payer: BCBS Complete |
$619.60
|
| Rate for Payer: BCBS MAPPO |
$345.81
|
| Rate for Payer: BCN Medicare Advantage |
$345.81
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cash Price |
$1,239.20
|
| Rate for Payer: Cofinity Commercial |
$497.97
|
| Rate for Payer: Cofinity Commercial |
$463.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$345.81
|
| Rate for Payer: Healthscope Commercial |
$414.97
|
| Rate for Payer: Healthscope Whirlpool |
$414.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$363.10
|
| Rate for Payer: Nomi Health Commercial |
$414.97
|
| Rate for Payer: PACE SWMI |
$345.81
|
| Rate for Payer: PHP Medicare Advantage |
$345.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,006.85
|
| Rate for Payer: Priority Health Medicare |
$345.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$345.81
|
| Rate for Payer: UHC Medicare Advantage |
$345.81
|
| Rate for Payer: UHCCP DNSP |
$345.81
|
|
|
PR DIVISION STRICTURE RECTUM
|
Professional
|
Both
|
$1,380.00
|
|
|
Service Code
|
HCPCS 45150
|
| Min. Negotiated Rate |
$410.86 |
| Max. Negotiated Rate |
$897.00 |
| Rate for Payer: Aetna Commercial |
$550.55
|
| Rate for Payer: Aetna Medicare |
$410.86
|
| Rate for Payer: BCBS Complete |
$552.00
|
| Rate for Payer: BCBS MAPPO |
$410.86
|
| Rate for Payer: BCN Medicare Advantage |
$410.86
|
| Rate for Payer: Cash Price |
$1,104.00
|
| Rate for Payer: Cash Price |
$1,104.00
|
| Rate for Payer: Cofinity Commercial |
$591.64
|
| Rate for Payer: Cofinity Commercial |
$550.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.86
|
| Rate for Payer: Healthscope Commercial |
$493.03
|
| Rate for Payer: Healthscope Whirlpool |
$493.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$431.40
|
| Rate for Payer: Nomi Health Commercial |
$493.03
|
| Rate for Payer: PACE SWMI |
$410.86
|
| Rate for Payer: PHP Medicare Advantage |
$410.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.00
|
| Rate for Payer: Priority Health Medicare |
$410.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$410.86
|
| Rate for Payer: UHC Medicare Advantage |
$410.86
|
| Rate for Payer: UHCCP DNSP |
$410.86
|
|
|
PR DLYD PLACEMENT XTN PROSTH FOR EVASC RPR 1ST VSL
|
Professional
|
Both
|
$1,681.00
|
|
|
Service Code
|
HCPCS 34710
|
| Min. Negotiated Rate |
$672.40 |
| Max. Negotiated Rate |
$1,096.52 |
| Rate for Payer: Aetna Commercial |
$1,020.37
|
| Rate for Payer: Aetna Medicare |
$761.47
|
| Rate for Payer: BCBS Complete |
$672.40
|
| Rate for Payer: BCBS MAPPO |
$761.47
|
| Rate for Payer: BCN Medicare Advantage |
$761.47
|
| Rate for Payer: Cash Price |
$1,344.80
|
| Rate for Payer: Cash Price |
$1,344.80
|
| Rate for Payer: Cofinity Commercial |
$1,096.52
|
| Rate for Payer: Cofinity Commercial |
$1,020.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$761.47
|
| Rate for Payer: Healthscope Commercial |
$913.76
|
| Rate for Payer: Healthscope Whirlpool |
$913.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$799.54
|
| Rate for Payer: Nomi Health Commercial |
$913.76
|
| Rate for Payer: PACE SWMI |
$761.47
|
| Rate for Payer: PHP Medicare Advantage |
$761.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,092.65
|
| Rate for Payer: Priority Health Medicare |
$761.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$761.47
|
| Rate for Payer: UHC Medicare Advantage |
$761.47
|
| Rate for Payer: UHCCP DNSP |
$761.47
|
|
|
PR DLYD PLACEMENT XTN PROSTH FOR EVASC RPR EA ADDL
|
Professional
|
Both
|
$629.00
|
|
|
Service Code
|
HCPCS 34711
|
| Min. Negotiated Rate |
$251.60 |
| Max. Negotiated Rate |
$408.85 |
| Rate for Payer: Aetna Commercial |
$379.70
|
| Rate for Payer: Aetna Medicare |
$283.36
|
| Rate for Payer: BCBS Complete |
$251.60
|
| Rate for Payer: BCBS MAPPO |
$283.36
|
| Rate for Payer: BCN Medicare Advantage |
$283.36
|
| Rate for Payer: Cash Price |
$503.20
|
| Rate for Payer: Cash Price |
$503.20
|
| Rate for Payer: Cofinity Commercial |
$408.04
|
| Rate for Payer: Cofinity Commercial |
$379.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$283.36
|
| Rate for Payer: Healthscope Commercial |
$340.03
|
| Rate for Payer: Healthscope Whirlpool |
$340.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$297.53
|
| Rate for Payer: Nomi Health Commercial |
$340.03
|
| Rate for Payer: PACE SWMI |
$283.36
|
| Rate for Payer: PHP Medicare Advantage |
$283.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.85
|
| Rate for Payer: Priority Health Medicare |
$283.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$283.36
|
| Rate for Payer: UHC Medicare Advantage |
$283.36
|
| Rate for Payer: UHCCP DNSP |
$283.36
|
|
|
PR DOG EAR REVISION
|
Professional
|
Both
|
$1,845.00
|
|
|
Service Code
|
HCPCS 00565
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$738.00 |
| Max. Negotiated Rate |
$1,199.25 |
| Rate for Payer: Aetna Medicare |
$922.50
|
| Rate for Payer: BCBS Complete |
$738.00
|
| Rate for Payer: Cash Price |
$1,476.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,199.25
|
|
|
PR DOMICIL/REST HOME NEW PT VISIT LOW SEVER 20 MIN
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 99324
|
| Min. Negotiated Rate |
$36.80 |
| Max. Negotiated Rate |
$59.80 |
| Rate for Payer: Aetna Medicare |
$46.00
|
| Rate for Payer: BCBS Complete |
$36.80
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
|
|
PR DOM/R-HOME E/M EST PT LW MOD SEVERITY 25 MINUTES
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 99335
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$92.95 |
| Rate for Payer: Aetna Medicare |
$71.50
|
| Rate for Payer: BCBS Complete |
$57.20
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
|
|
PR DOM/R-HOME E/M EST PT MOD HI SEVERITY 40 MINUTES
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 99336
|
| Min. Negotiated Rate |
$80.80 |
| Max. Negotiated Rate |
$131.30 |
| Rate for Payer: Aetna Medicare |
$101.00
|
| Rate for Payer: BCBS Complete |
$80.80
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.30
|
|
|
PR DOM/R-HOME E/M EST PT SELF-LMTD/MINOR 15 MINUTES
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 99334
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$59.15 |
| Rate for Payer: Aetna Medicare |
$45.50
|
| Rate for Payer: BCBS Complete |
$36.40
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.15
|
|
|
PR DOM/R-HOME E/M EST PT SIGNIF NEW PROB 60 MINUTES
|
Professional
|
Both
|
$289.00
|
|
|
Service Code
|
HCPCS 99337
|
| Min. Negotiated Rate |
$115.60 |
| Max. Negotiated Rate |
$187.85 |
| Rate for Payer: Aetna Medicare |
$144.50
|
| Rate for Payer: BCBS Complete |
$115.60
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$187.85
|
|
|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Facility
|
OP
|
$201.00
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
93325
|
| Min. Negotiated Rate |
$80.40 |
| Max. Negotiated Rate |
$201.00 |
| Rate for Payer: Aetna Commercial |
$180.90
|
| Rate for Payer: Aetna Commercial |
$297.00
|
| Rate for Payer: Aetna Medicare |
$100.50
|
| Rate for Payer: Aetna Medicare |
$165.00
|
| Rate for Payer: ASR ASR |
$194.97
|
| Rate for Payer: ASR ASR |
$320.10
|
| Rate for Payer: ASR Commercial |
$320.10
|
| Rate for Payer: ASR Commercial |
$194.97
|
| Rate for Payer: BCBS Complete |
$80.40
|
| Rate for Payer: BCBS Complete |
$132.00
|
| Rate for Payer: BCBS Trust/PPO |
$164.60
|
| Rate for Payer: BCBS Trust/PPO |
$270.24
|
| Rate for Payer: BCN Commercial |
$255.85
|
| Rate for Payer: BCN Commercial |
$155.84
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$188.94
|
| Rate for Payer: Cofinity Commercial |
$310.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.00
|
| Rate for Payer: Healthscope Commercial |
$201.00
|
| Rate for Payer: Healthscope Commercial |
$330.00
|
| Rate for Payer: Healthscope Whirlpool |
$194.97
|
| Rate for Payer: Healthscope Whirlpool |
$320.10
|
| Rate for Payer: Mclaren Commercial |
$180.90
|
| Rate for Payer: Mclaren Commercial |
$297.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.85
|
| Rate for Payer: Nomi Health Commercial |
$164.82
|
| Rate for Payer: Nomi Health Commercial |
$270.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$176.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$289.15
|
| Rate for Payer: Priority Health Narrow Network |
$231.33
|
| Rate for Payer: Priority Health Narrow Network |
$140.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.88
|
|
|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 93325
|
| Hospital Charge Code |
93325
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$130.65 |
| Rate for Payer: Aetna Commercial |
$27.12
|
| Rate for Payer: Aetna Commercial |
$27.12
|
| Rate for Payer: Aetna Medicare |
$20.24
|
| Rate for Payer: Aetna Medicare |
$20.24
|
| Rate for Payer: BCBS Complete |
$132.00
|
| Rate for Payer: BCBS Complete |
$80.40
|
| Rate for Payer: BCBS MAPPO |
$20.24
|
| Rate for Payer: BCBS MAPPO |
$20.24
|
| Rate for Payer: BCN Medicare Advantage |
$20.24
|
| Rate for Payer: BCN Medicare Advantage |
$20.24
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$27.12
|
| Rate for Payer: Cofinity Commercial |
$29.15
|
| Rate for Payer: Cofinity Commercial |
$27.12
|
| Rate for Payer: Cofinity Commercial |
$29.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.24
|
| Rate for Payer: Healthscope Commercial |
$24.29
|
| Rate for Payer: Healthscope Commercial |
$24.29
|
| Rate for Payer: Healthscope Whirlpool |
$24.29
|
| Rate for Payer: Healthscope Whirlpool |
$24.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.25
|
| Rate for Payer: Nomi Health Commercial |
$24.29
|
| Rate for Payer: Nomi Health Commercial |
$24.29
|
| Rate for Payer: PACE SWMI |
$20.24
|
| Rate for Payer: PACE SWMI |
$20.24
|
| Rate for Payer: PHP Medicare Advantage |
$20.24
|
| Rate for Payer: PHP Medicare Advantage |
$20.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health Medicare |
$20.24
|
| Rate for Payer: Priority Health Medicare |
$20.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.24
|
| Rate for Payer: UHC Medicare Advantage |
$20.24
|
| Rate for Payer: UHC Medicare Advantage |
$20.24
|
| Rate for Payer: UHCCP DNSP |
$20.24
|
| Rate for Payer: UHCCP DNSP |
$20.24
|
|
|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Professional
|
Both
|
$201.00
|
|
|
Service Code
|
HCPCS 93325
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$130.65 |
| Rate for Payer: Aetna Commercial |
$27.12
|
| Rate for Payer: Aetna Commercial |
$27.12
|
| Rate for Payer: Aetna Medicare |
$20.24
|
| Rate for Payer: Aetna Medicare |
$20.24
|
| Rate for Payer: BCBS Complete |
$132.00
|
| Rate for Payer: BCBS Complete |
$80.40
|
| Rate for Payer: BCBS MAPPO |
$20.24
|
| Rate for Payer: BCBS MAPPO |
$20.24
|
| Rate for Payer: BCN Medicare Advantage |
$20.24
|
| Rate for Payer: BCN Medicare Advantage |
$20.24
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cofinity Commercial |
$27.12
|
| Rate for Payer: Cofinity Commercial |
$27.12
|
| Rate for Payer: Cofinity Commercial |
$29.15
|
| Rate for Payer: Cofinity Commercial |
$29.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.24
|
| Rate for Payer: Healthscope Commercial |
$24.29
|
| Rate for Payer: Healthscope Commercial |
$24.29
|
| Rate for Payer: Healthscope Whirlpool |
$24.29
|
| Rate for Payer: Healthscope Whirlpool |
$24.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.25
|
| Rate for Payer: Nomi Health Commercial |
$24.29
|
| Rate for Payer: Nomi Health Commercial |
$24.29
|
| Rate for Payer: PACE SWMI |
$20.24
|
| Rate for Payer: PACE SWMI |
$20.24
|
| Rate for Payer: PHP Medicare Advantage |
$20.24
|
| Rate for Payer: PHP Medicare Advantage |
$20.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: Priority Health Medicare |
$20.24
|
| Rate for Payer: Priority Health Medicare |
$20.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.24
|
| Rate for Payer: UHC Medicare Advantage |
$20.24
|
| Rate for Payer: UHC Medicare Advantage |
$20.24
|
| Rate for Payer: UHCCP DNSP |
$20.24
|
| Rate for Payer: UHCCP DNSP |
$20.24
|
|
|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Facility
|
IP
|
$330.00
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
93325
|
| Min. Negotiated Rate |
$214.50 |
| Max. Negotiated Rate |
$330.00 |
| Rate for Payer: Aetna Commercial |
$297.00
|
| Rate for Payer: Aetna Commercial |
$180.90
|
| Rate for Payer: ASR ASR |
$194.97
|
| Rate for Payer: ASR ASR |
$320.10
|
| Rate for Payer: ASR Commercial |
$194.97
|
| Rate for Payer: ASR Commercial |
$320.10
|
| Rate for Payer: BCBS Trust/PPO |
$163.79
|
| Rate for Payer: BCBS Trust/PPO |
$268.92
|
| Rate for Payer: BCN Commercial |
$255.85
|
| Rate for Payer: BCN Commercial |
$155.84
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cofinity Commercial |
$188.94
|
| Rate for Payer: Cofinity Commercial |
$310.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.00
|
| Rate for Payer: Healthscope Commercial |
$201.00
|
| Rate for Payer: Healthscope Commercial |
$330.00
|
| Rate for Payer: Healthscope Whirlpool |
$320.10
|
| Rate for Payer: Healthscope Whirlpool |
$194.97
|
| Rate for Payer: Mclaren Commercial |
$180.90
|
| Rate for Payer: Mclaren Commercial |
$297.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.85
|
| Rate for Payer: Nomi Health Commercial |
$270.60
|
| Rate for Payer: Nomi Health Commercial |
$164.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$290.40
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Facility
|
OP
|
$176.00
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
93320
|
| Min. Negotiated Rate |
$70.40 |
| Max. Negotiated Rate |
$176.00 |
| Rate for Payer: Aetna Commercial |
$158.40
|
| Rate for Payer: Aetna Commercial |
$233.10
|
| Rate for Payer: Aetna Medicare |
$88.00
|
| Rate for Payer: Aetna Medicare |
$129.50
|
| Rate for Payer: ASR ASR |
$170.72
|
| Rate for Payer: ASR ASR |
$251.23
|
| Rate for Payer: ASR Commercial |
$251.23
|
| Rate for Payer: ASR Commercial |
$170.72
|
| Rate for Payer: BCBS Complete |
$70.40
|
| Rate for Payer: BCBS Complete |
$103.60
|
| Rate for Payer: BCBS Trust/PPO |
$144.13
|
| Rate for Payer: BCBS Trust/PPO |
$212.10
|
| Rate for Payer: BCN Commercial |
$200.80
|
| Rate for Payer: BCN Commercial |
$136.45
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$165.44
|
| Rate for Payer: Cofinity Commercial |
$243.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.20
|
| Rate for Payer: Healthscope Commercial |
$176.00
|
| Rate for Payer: Healthscope Commercial |
$259.00
|
| Rate for Payer: Healthscope Whirlpool |
$170.72
|
| Rate for Payer: Healthscope Whirlpool |
$251.23
|
| Rate for Payer: Mclaren Commercial |
$158.40
|
| Rate for Payer: Mclaren Commercial |
$233.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.60
|
| Rate for Payer: Nomi Health Commercial |
$144.32
|
| Rate for Payer: Nomi Health Commercial |
$212.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$154.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$226.94
|
| Rate for Payer: Priority Health Narrow Network |
$181.56
|
| Rate for Payer: Priority Health Narrow Network |
$123.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$227.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$154.88
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 93320
|
| Min. Negotiated Rate |
$45.46 |
| Max. Negotiated Rate |
$114.40 |
| Rate for Payer: Aetna Commercial |
$60.92
|
| Rate for Payer: Aetna Commercial |
$60.92
|
| Rate for Payer: Aetna Medicare |
$45.46
|
| Rate for Payer: Aetna Medicare |
$45.46
|
| Rate for Payer: BCBS Complete |
$103.60
|
| Rate for Payer: BCBS Complete |
$70.40
|
| Rate for Payer: BCBS MAPPO |
$45.46
|
| Rate for Payer: BCBS MAPPO |
$45.46
|
| Rate for Payer: BCN Medicare Advantage |
$45.46
|
| Rate for Payer: BCN Medicare Advantage |
$45.46
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$60.92
|
| Rate for Payer: Cofinity Commercial |
$65.46
|
| Rate for Payer: Cofinity Commercial |
$60.92
|
| Rate for Payer: Cofinity Commercial |
$65.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.46
|
| Rate for Payer: Healthscope Commercial |
$54.55
|
| Rate for Payer: Healthscope Commercial |
$54.55
|
| Rate for Payer: Healthscope Whirlpool |
$54.55
|
| Rate for Payer: Healthscope Whirlpool |
$54.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.73
|
| Rate for Payer: Nomi Health Commercial |
$54.55
|
| Rate for Payer: Nomi Health Commercial |
$54.55
|
| Rate for Payer: PACE SWMI |
$45.46
|
| Rate for Payer: PACE SWMI |
$45.46
|
| Rate for Payer: PHP Medicare Advantage |
$45.46
|
| Rate for Payer: PHP Medicare Advantage |
$45.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health Medicare |
$45.46
|
| Rate for Payer: Priority Health Medicare |
$45.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$45.46
|
| Rate for Payer: UHCCP DNSP |
$45.46
|
| Rate for Payer: UHCCP DNSP |
$45.46
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 93320
|
| Hospital Charge Code |
93320
|
| Min. Negotiated Rate |
$45.46 |
| Max. Negotiated Rate |
$114.40 |
| Rate for Payer: Aetna Commercial |
$60.92
|
| Rate for Payer: Aetna Commercial |
$60.92
|
| Rate for Payer: Aetna Medicare |
$45.46
|
| Rate for Payer: Aetna Medicare |
$45.46
|
| Rate for Payer: BCBS Complete |
$103.60
|
| Rate for Payer: BCBS Complete |
$70.40
|
| Rate for Payer: BCBS MAPPO |
$45.46
|
| Rate for Payer: BCBS MAPPO |
$45.46
|
| Rate for Payer: BCN Medicare Advantage |
$45.46
|
| Rate for Payer: BCN Medicare Advantage |
$45.46
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cofinity Commercial |
$60.92
|
| Rate for Payer: Cofinity Commercial |
$65.46
|
| Rate for Payer: Cofinity Commercial |
$60.92
|
| Rate for Payer: Cofinity Commercial |
$65.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.46
|
| Rate for Payer: Healthscope Commercial |
$54.55
|
| Rate for Payer: Healthscope Commercial |
$54.55
|
| Rate for Payer: Healthscope Whirlpool |
$54.55
|
| Rate for Payer: Healthscope Whirlpool |
$54.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.73
|
| Rate for Payer: Nomi Health Commercial |
$54.55
|
| Rate for Payer: Nomi Health Commercial |
$54.55
|
| Rate for Payer: PACE SWMI |
$45.46
|
| Rate for Payer: PACE SWMI |
$45.46
|
| Rate for Payer: PHP Medicare Advantage |
$45.46
|
| Rate for Payer: PHP Medicare Advantage |
$45.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health Medicare |
$45.46
|
| Rate for Payer: Priority Health Medicare |
$45.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$45.46
|
| Rate for Payer: UHC Medicare Advantage |
$45.46
|
| Rate for Payer: UHCCP DNSP |
$45.46
|
| Rate for Payer: UHCCP DNSP |
$45.46
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Facility
|
IP
|
$259.00
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
93320
|
| Min. Negotiated Rate |
$168.35 |
| Max. Negotiated Rate |
$259.00 |
| Rate for Payer: Aetna Commercial |
$233.10
|
| Rate for Payer: Aetna Commercial |
$158.40
|
| Rate for Payer: ASR ASR |
$170.72
|
| Rate for Payer: ASR ASR |
$251.23
|
| Rate for Payer: ASR Commercial |
$170.72
|
| Rate for Payer: ASR Commercial |
$251.23
|
| Rate for Payer: BCBS Trust/PPO |
$143.42
|
| Rate for Payer: BCBS Trust/PPO |
$211.06
|
| Rate for Payer: BCN Commercial |
$200.80
|
| Rate for Payer: BCN Commercial |
$136.45
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cofinity Commercial |
$165.44
|
| Rate for Payer: Cofinity Commercial |
$243.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.20
|
| Rate for Payer: Healthscope Commercial |
$176.00
|
| Rate for Payer: Healthscope Commercial |
$259.00
|
| Rate for Payer: Healthscope Whirlpool |
$251.23
|
| Rate for Payer: Healthscope Whirlpool |
$170.72
|
| Rate for Payer: Mclaren Commercial |
$158.40
|
| Rate for Payer: Mclaren Commercial |
$233.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.60
|
| Rate for Payer: Nomi Health Commercial |
$212.38
|
| Rate for Payer: Nomi Health Commercial |
$144.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$154.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$227.92
|
|
