|
PR DIVISION STRICTURE RECTUM
|
Professional
|
Both
|
$1,380.00
|
|
|
Service Code
|
HCPCS 45150
|
| Min. Negotiated Rate |
$275.62 |
| Max. Negotiated Rate |
$897.00 |
| Rate for Payer: Aetna Commercial |
$565.98
|
| Rate for Payer: Aetna Medicare |
$690.00
|
| Rate for Payer: BCBS Complete |
$289.40
|
| Rate for Payer: BCN Commercial |
$622.57
|
| Rate for Payer: Cash Price |
$1,104.00
|
| Rate for Payer: Cash Price |
$1,104.00
|
| Rate for Payer: Meridian Medicaid |
$289.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$897.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$766.62
|
| Rate for Payer: Priority Health Narrow Network |
$766.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$465.03
|
| Rate for Payer: UHC Exchange |
$465.03
|
| Rate for Payer: UHCCP Medicaid |
$275.62
|
|
|
PR DLYD PLACEMENT XTN PROSTH FOR EVASC RPR 1ST VSL
|
Professional
|
Both
|
$1,681.00
|
|
|
Service Code
|
HCPCS 34710
|
| Min. Negotiated Rate |
$497.14 |
| Max. Negotiated Rate |
$1,852.75 |
| Rate for Payer: Aetna Commercial |
$1,070.75
|
| Rate for Payer: Aetna Medicare |
$840.50
|
| Rate for Payer: BCBS Complete |
$522.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,852.75
|
| Rate for Payer: BCN Commercial |
$1,133.25
|
| Rate for Payer: Cash Price |
$1,344.80
|
| Rate for Payer: Cash Price |
$1,344.80
|
| Rate for Payer: Meridian Medicaid |
$522.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$497.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,092.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,239.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,239.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,074.85
|
| Rate for Payer: UHC Exchange |
$1,074.85
|
| Rate for Payer: UHCCP Medicaid |
$497.14
|
|
|
PR DLYD PLACEMENT XTN PROSTH FOR EVASC RPR EA ADDL
|
Professional
|
Both
|
$629.00
|
|
|
Service Code
|
HCPCS 34711
|
| Min. Negotiated Rate |
$183.39 |
| Max. Negotiated Rate |
$1,060.83 |
| Rate for Payer: Aetna Commercial |
$402.19
|
| Rate for Payer: Aetna Medicare |
$314.50
|
| Rate for Payer: BCBS Complete |
$192.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,060.83
|
| Rate for Payer: BCN Commercial |
$418.30
|
| Rate for Payer: Cash Price |
$503.20
|
| Rate for Payer: Cash Price |
$503.20
|
| Rate for Payer: Meridian Medicaid |
$192.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$183.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.31
|
| Rate for Payer: Priority Health Narrow Network |
$456.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$401.69
|
| Rate for Payer: UHC Exchange |
$401.69
|
| Rate for Payer: UHCCP Medicaid |
$183.39
|
|
|
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
|
IP
|
$201.00
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
93325
|
| Min. Negotiated Rate |
$130.65 |
| Max. Negotiated Rate |
$201.00 |
| Rate for Payer: Aetna Commercial |
$180.90
|
| Rate for Payer: Aetna Commercial |
$297.00
|
| 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 |
$290.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$176.88
|
|
|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 93325
|
| Min. Negotiated Rate |
$1.92 |
| Max. Negotiated Rate |
$2,792.59 |
| Rate for Payer: Aetna Commercial |
$31.62
|
| Rate for Payer: Aetna Commercial |
$31.62
|
| Rate for Payer: Aetna Medicare |
$165.00
|
| Rate for Payer: Aetna Medicare |
$100.50
|
| Rate for Payer: BCBS Complete |
$2.02
|
| Rate for Payer: BCBS Complete |
$2.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,792.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,792.59
|
| Rate for Payer: BCN Commercial |
$34.21
|
| Rate for Payer: BCN Commercial |
$34.21
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Meridian Medicaid |
$2.02
|
| Rate for Payer: Meridian Medicaid |
$2.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.92
|
| 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 HMO/PPO/Tiered Network |
$4.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.24
|
| Rate for Payer: Priority Health Narrow Network |
$4.24
|
| Rate for Payer: Priority Health Narrow Network |
$4.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.45
|
| Rate for Payer: UHC Exchange |
$49.45
|
| Rate for Payer: UHC Exchange |
$49.45
|
| Rate for Payer: UHCCP Medicaid |
$1.92
|
| Rate for Payer: UHCCP Medicaid |
$1.92
|
|
|
PR DOPPLER ECHO COLOR FLOW VELOCITY MAPPING
|
Facility
|
OP
|
$330.00
|
|
|
Service Code
|
CPT 93325
|
| Hospital Charge Code |
93325
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$390.35 |
| Rate for Payer: Aetna Commercial |
$297.00
|
| Rate for Payer: Aetna Commercial |
$180.90
|
| Rate for Payer: Aetna Medicare |
$100.50
|
| Rate for Payer: Aetna Medicare |
$165.00
|
| Rate for Payer: ASR ASR |
$320.10
|
| Rate for Payer: ASR ASR |
$194.97
|
| Rate for Payer: ASR Commercial |
$320.10
|
| Rate for Payer: ASR Commercial |
$194.97
|
| Rate for Payer: BCBS Complete |
$132.00
|
| Rate for Payer: BCBS Complete |
$80.40
|
| Rate for Payer: BCBS Trust/PPO |
$270.24
|
| Rate for Payer: BCBS Trust/PPO |
$164.60
|
| 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 |
$160.80
|
| Rate for Payer: Cash Price |
$264.00
|
| 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 |
$264.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.80
|
| Rate for Payer: Healthscope Commercial |
$330.00
|
| Rate for Payer: Healthscope Commercial |
$201.00
|
| 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 |
$170.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.50
|
| Rate for Payer: Nomi Health Commercial |
$164.82
|
| Rate for Payer: Nomi Health Commercial |
$270.60
|
| 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 HMO/PPO/Tiered Network |
$390.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$390.35
|
| Rate for Payer: Priority Health Narrow Network |
$312.28
|
| Rate for Payer: Priority Health Narrow Network |
$312.28
|
| 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 |
$1.92 |
| Max. Negotiated Rate |
$2,792.59 |
| Rate for Payer: Aetna Commercial |
$31.62
|
| Rate for Payer: Aetna Commercial |
$31.62
|
| Rate for Payer: Aetna Medicare |
$165.00
|
| Rate for Payer: Aetna Medicare |
$100.50
|
| Rate for Payer: BCBS Complete |
$2.02
|
| Rate for Payer: BCBS Complete |
$2.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,792.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,792.59
|
| Rate for Payer: BCN Commercial |
$34.21
|
| Rate for Payer: BCN Commercial |
$34.21
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Cash Price |
$160.80
|
| Rate for Payer: Meridian Medicaid |
$2.02
|
| Rate for Payer: Meridian Medicaid |
$2.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.92
|
| 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 HMO/PPO/Tiered Network |
$4.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.24
|
| Rate for Payer: Priority Health Narrow Network |
$4.24
|
| Rate for Payer: Priority Health Narrow Network |
$4.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.45
|
| Rate for Payer: UHC Exchange |
$49.45
|
| Rate for Payer: UHC Exchange |
$49.45
|
| Rate for Payer: UHCCP Medicaid |
$1.92
|
| Rate for Payer: UHCCP Medicaid |
$1.92
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 93320
|
| Hospital Charge Code |
93320
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$1,902.94 |
| Rate for Payer: Aetna Commercial |
$68.60
|
| Rate for Payer: Aetna Commercial |
$68.60
|
| Rate for Payer: Aetna Medicare |
$88.00
|
| Rate for Payer: Aetna Medicare |
$129.50
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,902.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,902.94
|
| Rate for Payer: BCN Commercial |
$73.79
|
| Rate for Payer: BCN Commercial |
$73.79
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.48
|
| Rate for Payer: Priority Health Narrow Network |
$24.48
|
| Rate for Payer: Priority Health Narrow Network |
$24.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.25
|
| Rate for Payer: UHC Exchange |
$83.25
|
| Rate for Payer: UHC Exchange |
$83.25
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 93320
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$1,902.94 |
| Rate for Payer: Aetna Commercial |
$68.60
|
| Rate for Payer: Aetna Commercial |
$68.60
|
| Rate for Payer: Aetna Medicare |
$129.50
|
| Rate for Payer: Aetna Medicare |
$88.00
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: BCBS Trust/PPO |
$1,902.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,902.94
|
| Rate for Payer: BCN Commercial |
$73.79
|
| Rate for Payer: BCN Commercial |
$73.79
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$207.20
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: Meridian Medicaid |
$11.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.48
|
| Rate for Payer: Priority Health Narrow Network |
$24.48
|
| Rate for Payer: Priority Health Narrow Network |
$24.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.25
|
| Rate for Payer: UHC Exchange |
$83.25
|
| Rate for Payer: UHC Exchange |
$83.25
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
| Rate for Payer: UHCCP Medicaid |
$11.08
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL DISPLAY COMPL
|
Facility
|
OP
|
$259.00
|
|
|
Service Code
|
CPT 93320
|
| Hospital Charge Code |
93320
|
| Min. Negotiated Rate |
$103.60 |
| Max. Negotiated Rate |
$390.35 |
| Rate for Payer: Aetna Commercial |
$233.10
|
| Rate for Payer: Aetna Commercial |
$158.40
|
| Rate for Payer: Aetna Medicare |
$88.00
|
| Rate for Payer: Aetna Medicare |
$129.50
|
| Rate for Payer: ASR ASR |
$251.23
|
| Rate for Payer: ASR ASR |
$170.72
|
| Rate for Payer: ASR Commercial |
$251.23
|
| Rate for Payer: ASR Commercial |
$170.72
|
| Rate for Payer: BCBS Complete |
$103.60
|
| Rate for Payer: BCBS Complete |
$70.40
|
| Rate for Payer: BCBS Trust/PPO |
$212.10
|
| Rate for Payer: BCBS Trust/PPO |
$144.13
|
| 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 |
$140.80
|
| Rate for Payer: Cash Price |
$207.20
|
| 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 |
$207.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.80
|
| Rate for Payer: Healthscope Commercial |
$259.00
|
| Rate for Payer: Healthscope Commercial |
$176.00
|
| 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 |
$149.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.15
|
| Rate for Payer: Nomi Health Commercial |
$144.32
|
| Rate for Payer: Nomi Health Commercial |
$212.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$390.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$390.35
|
| Rate for Payer: Priority Health Narrow Network |
$312.28
|
| Rate for Payer: Priority Health Narrow Network |
$312.28
|
| 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
|
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 |
$211.06
|
| Rate for Payer: BCBS Trust/PPO |
$143.42
|
| 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 |
$207.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.80
|
| 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 |
$233.10
|
| Rate for Payer: Mclaren Commercial |
$158.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.15
|
| Rate for Payer: Nomi Health Commercial |
$144.32
|
| Rate for Payer: Nomi Health Commercial |
$212.38
|
| 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
|
|
|
PR DOPPLER ECHO PULSE WAVE W/SPECTRAL F-UP/LMTD STD
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 93321
|
| Min. Negotiated Rate |
$4.47 |
| Max. Negotiated Rate |
$2,553.80 |
| Rate for Payer: Aetna Commercial |
$34.13
|
| Rate for Payer: Aetna Medicare |
$27.00
|
| Rate for Payer: BCBS Complete |
$4.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,553.80
|
| Rate for Payer: BCN Commercial |
$36.65
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Meridian Medicaid |
$4.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.89
|
| Rate for Payer: Priority Health Narrow Network |
$9.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.63
|
| Rate for Payer: UHC Exchange |
$37.63
|
| Rate for Payer: UHCCP Medicaid |
$4.47
|
|
|
PR DRAIN ABD ABSCESS PERCUTANEOUS
|
Professional
|
Both
|
$619.00
|
|
|
Service Code
|
HCPCS 49021
|
| Min. Negotiated Rate |
$247.60 |
| Max. Negotiated Rate |
$402.35 |
| Rate for Payer: Aetna Medicare |
$309.50
|
| Rate for Payer: BCBS Complete |
$247.60
|
| Rate for Payer: Cash Price |
$495.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$402.35
|
|
|
PR DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH
|
Professional
|
Both
|
$374.00
|
|
|
Service Code
|
HCPCS 30000
|
| Min. Negotiated Rate |
$79.02 |
| Max. Negotiated Rate |
$1,942.56 |
| Rate for Payer: Aetna Commercial |
$150.43
|
| Rate for Payer: Aetna Medicare |
$187.00
|
| Rate for Payer: BCBS Complete |
$82.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,942.56
|
| Rate for Payer: BCN Commercial |
$396.81
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Cash Price |
$299.20
|
| Rate for Payer: Meridian Medicaid |
$82.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$170.10
|
| Rate for Payer: Priority Health Narrow Network |
$170.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$129.26
|
| Rate for Payer: UHC Exchange |
$129.26
|
| Rate for Payer: UHCCP Medicaid |
$79.02
|
|
|
PR DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM
|
Professional
|
Both
|
$304.00
|
|
|
Service Code
|
HCPCS 30020
|
| Min. Negotiated Rate |
$79.24 |
| Max. Negotiated Rate |
$1,109.43 |
| Rate for Payer: Aetna Commercial |
$151.26
|
| Rate for Payer: Aetna Medicare |
$152.00
|
| Rate for Payer: BCBS Complete |
$83.20
|
| Rate for Payer: BCBS Trust/PPO |
$1,109.43
|
| Rate for Payer: BCN Commercial |
$401.20
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Meridian Medicaid |
$83.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$197.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.41
|
| Rate for Payer: Priority Health Narrow Network |
$172.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$130.02
|
| Rate for Payer: UHC Exchange |
$130.02
|
| Rate for Payer: UHCCP Medicaid |
$79.24
|
|
|
PR DRAINAGE ABSCESS PALATE UVULA
|
Professional
|
Both
|
$336.00
|
|
|
Service Code
|
HCPCS 42000
|
| Min. Negotiated Rate |
$70.72 |
| Max. Negotiated Rate |
$237.98 |
| Rate for Payer: Aetna Commercial |
$138.08
|
| Rate for Payer: Aetna Medicare |
$168.00
|
| Rate for Payer: BCBS Complete |
$74.26
|
| Rate for Payer: BCN Commercial |
$237.98
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Meridian Medicaid |
$74.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.47
|
| Rate for Payer: Priority Health Narrow Network |
$197.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$123.08
|
| Rate for Payer: UHC Exchange |
$123.08
|
| Rate for Payer: UHCCP Medicaid |
$70.72
|
|
|
PR DRAINAGE ABSCESS PAROTID COMPLICATED
|
Professional
|
Both
|
$783.00
|
|
|
Service Code
|
HCPCS 42305
|
| Min. Negotiated Rate |
$200.75 |
| Max. Negotiated Rate |
$783.32 |
| Rate for Payer: Aetna Commercial |
$561.76
|
| Rate for Payer: Aetna Medicare |
$391.50
|
| Rate for Payer: BCBS Complete |
$294.33
|
| Rate for Payer: BCBS Trust/PPO |
$200.75
|
| Rate for Payer: BCN Commercial |
$621.60
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Meridian Medicaid |
$294.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$280.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$508.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$783.32
|
| Rate for Payer: Priority Health Narrow Network |
$783.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$524.91
|
| Rate for Payer: UHC Exchange |
$524.91
|
| Rate for Payer: UHCCP Medicaid |
$280.31
|
|
|
PR DRAINAGE ABSCESS PAROTID SIMPLE
|
Professional
|
Both
|
$349.00
|
|
|
Service Code
|
HCPCS 42300
|
| Min. Negotiated Rate |
$101.18 |
| Max. Negotiated Rate |
$891.77 |
| Rate for Payer: Aetna Commercial |
$202.70
|
| Rate for Payer: Aetna Medicare |
$174.50
|
| Rate for Payer: BCBS Complete |
$106.24
|
| Rate for Payer: BCBS Trust/PPO |
$891.77
|
| Rate for Payer: BCN Commercial |
$319.11
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Cash Price |
$279.20
|
| Rate for Payer: Meridian Medicaid |
$106.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.78
|
| Rate for Payer: Priority Health Narrow Network |
$282.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.28
|
| Rate for Payer: UHC Exchange |
$183.28
|
| Rate for Payer: UHCCP Medicaid |
$101.18
|
|
|
PR DRAINAGE DEEP PERIURETHRAL ABSCESS
|
Professional
|
Both
|
$815.00
|
|
|
Service Code
|
HCPCS 53040
|
| Min. Negotiated Rate |
$253.26 |
| Max. Negotiated Rate |
$758.64 |
| Rate for Payer: Aetna Commercial |
$501.88
|
| Rate for Payer: Aetna Medicare |
$407.50
|
| Rate for Payer: BCBS Complete |
$265.92
|
| Rate for Payer: BCBS Trust/PPO |
$758.64
|
| Rate for Payer: BCN Commercial |
$568.33
|
| Rate for Payer: Cash Price |
$652.00
|
| Rate for Payer: Cash Price |
$652.00
|
| Rate for Payer: Meridian Medicaid |
$265.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$253.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$627.94
|
| Rate for Payer: Priority Health Narrow Network |
$627.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$469.03
|
| Rate for Payer: UHC Exchange |
$469.03
|
| Rate for Payer: UHCCP Medicaid |
$253.26
|
|
