|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Professional
|
Both
|
$1,489.00
|
|
|
Service Code
|
HCPCS 43246
|
| Hospital Charge Code |
43246
|
| Min. Negotiated Rate |
$113.74 |
| Max. Negotiated Rate |
$1,116.75 |
| Rate for Payer: Aetna Commercial |
$236.84
|
| Rate for Payer: Aetna Medicare |
$176.75
|
| Rate for Payer: BCBS Complete |
$119.43
|
| Rate for Payer: BCBS MAPPO |
$176.75
|
| Rate for Payer: BCN Commercial |
$295.80
|
| Rate for Payer: BCN Medicare Advantage |
$176.75
|
| Rate for Payer: Cash Price |
$1,191.20
|
| Rate for Payer: Cash Price |
$1,191.20
|
| Rate for Payer: Cofinity Commercial |
$254.52
|
| Rate for Payer: Cofinity Commercial |
$236.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.75
|
| Rate for Payer: Healthscope Commercial |
$212.10
|
| Rate for Payer: Healthscope Whirlpool |
$212.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.59
|
| Rate for Payer: Meridian Medicaid |
$119.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$194.43
|
| Rate for Payer: Nomi Health Commercial |
$212.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,116.75
|
| Rate for Payer: PACE SWMI |
$176.75
|
| Rate for Payer: PHP Medicare Advantage |
$176.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$113.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$360.42
|
| Rate for Payer: Priority Health Medicare |
$176.75
|
| Rate for Payer: Priority Health Narrow Network |
$360.42
|
| Rate for Payer: Railroad Medicare Medicare |
$176.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$354.94
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$176.75
|
| Rate for Payer: UHC Exchange |
$354.94
|
| Rate for Payer: UHC Medicaid |
$113.74
|
| Rate for Payer: UHCCP DNSP |
$176.75
|
| Rate for Payer: UHCCP Medicaid |
$113.74
|
|
|
PR EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE
|
Facility
|
OP
|
$1,489.00
|
|
|
Service Code
|
CPT 43246
|
| Hospital Charge Code |
43246
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$999.98 |
| Max. Negotiated Rate |
$2,390.01 |
| Rate for Payer: Aetna Commercial |
$1,340.10
|
| Rate for Payer: Aetna Medicare |
$1,912.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,390.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,390.01
|
| Rate for Payer: ASR ASR |
$1,444.33
|
| Rate for Payer: BCBS Complete |
$1,050.08
|
| Rate for Payer: BCBS MAPPO |
$1,912.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,227.68
|
| Rate for Payer: BCN Commercial |
$1,227.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,912.01
|
| Rate for Payer: Cash Price |
$1,191.20
|
| Rate for Payer: Cash Price |
$1,191.20
|
| Rate for Payer: Cofinity Commercial |
$1,399.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,191.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,912.01
|
| Rate for Payer: Healthscope Commercial |
$1,444.33
|
| Rate for Payer: Healthscope Whirlpool |
$1,489.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,912.01
|
| Rate for Payer: Mclaren Commercial |
$1,340.10
|
| Rate for Payer: Mclaren Medicaid |
$1,912.01
|
| Rate for Payer: Mclaren Medicare |
$1,912.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,007.61
|
| Rate for Payer: Meridian Medicaid |
$1,050.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,198.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,103.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,265.65
|
| Rate for Payer: Nomi Health Commercial |
$1,220.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,116.75
|
| Rate for Payer: PACE Medicare |
$1,816.41
|
| Rate for Payer: PACE SWMI |
$1,912.01
|
| Rate for Payer: PHP Commercial |
$2,103.21
|
| Rate for Payer: PHP Medicaid |
$1,024.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,912.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$999.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,304.66
|
| Rate for Payer: Priority Health Medicare |
$1,912.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,043.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,912.01
|
| Rate for Payer: UHC Medicaid |
$999.98
|
| Rate for Payer: UHCCP DNSP |
$1,912.01
|
| Rate for Payer: UHCCP Medicaid |
$999.98
|
| Rate for Payer: VA VA |
$1,912.01
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Facility
|
IP
|
$1,229.00
|
|
|
Service Code
|
CPT 43251
|
| Hospital Charge Code |
43251
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$921.75 |
| Max. Negotiated Rate |
$1,229.00 |
| Rate for Payer: Aetna Commercial |
$1,106.10
|
| Rate for Payer: ASR ASR |
$1,192.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,009.25
|
| Rate for Payer: BCN Commercial |
$1,009.25
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cofinity Commercial |
$1,155.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$983.20
|
| Rate for Payer: Healthscope Commercial |
$1,192.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,229.00
|
| Rate for Payer: Mclaren Commercial |
$1,106.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.65
|
| Rate for Payer: Nomi Health Commercial |
$1,007.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$921.75
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Professional
|
Both
|
$1,229.00
|
|
|
Service Code
|
HCPCS 43251
|
| Min. Negotiated Rate |
$110.33 |
| Max. Negotiated Rate |
$921.75 |
| Rate for Payer: Aetna Commercial |
$228.60
|
| Rate for Payer: Aetna Medicare |
$170.60
|
| Rate for Payer: BCBS Complete |
$115.85
|
| Rate for Payer: BCBS MAPPO |
$170.60
|
| Rate for Payer: BCN Commercial |
$288.83
|
| Rate for Payer: BCN Medicare Advantage |
$170.60
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cofinity Commercial |
$245.66
|
| Rate for Payer: Cofinity Commercial |
$228.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.60
|
| Rate for Payer: Healthscope Commercial |
$204.72
|
| Rate for Payer: Healthscope Whirlpool |
$204.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.13
|
| Rate for Payer: Meridian Medicaid |
$115.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$187.66
|
| Rate for Payer: Nomi Health Commercial |
$204.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$921.75
|
| Rate for Payer: PACE SWMI |
$170.60
|
| Rate for Payer: PHP Medicare Advantage |
$170.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$351.92
|
| Rate for Payer: Priority Health Medicare |
$170.60
|
| Rate for Payer: Priority Health Narrow Network |
$351.92
|
| Rate for Payer: Railroad Medicare Medicare |
$170.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$345.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$170.60
|
| Rate for Payer: UHC Exchange |
$345.84
|
| Rate for Payer: UHC Medicaid |
$110.33
|
| Rate for Payer: UHCCP DNSP |
$170.60
|
| Rate for Payer: UHCCP Medicaid |
$110.33
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Facility
|
OP
|
$1,229.00
|
|
|
Service Code
|
CPT 43251
|
| Hospital Charge Code |
43251
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$861.53 |
| Max. Negotiated Rate |
$2,390.01 |
| Rate for Payer: Aetna Commercial |
$1,106.10
|
| Rate for Payer: Aetna Medicare |
$1,912.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,390.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,390.01
|
| Rate for Payer: ASR ASR |
$1,192.13
|
| Rate for Payer: BCBS Complete |
$1,050.08
|
| Rate for Payer: BCBS MAPPO |
$1,912.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,013.31
|
| Rate for Payer: BCN Commercial |
$1,013.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,912.01
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cofinity Commercial |
$1,155.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$983.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,912.01
|
| Rate for Payer: Healthscope Commercial |
$1,192.13
|
| Rate for Payer: Healthscope Whirlpool |
$1,229.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,912.01
|
| Rate for Payer: Mclaren Commercial |
$1,106.10
|
| Rate for Payer: Mclaren Medicaid |
$1,912.01
|
| Rate for Payer: Mclaren Medicare |
$1,912.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,007.61
|
| Rate for Payer: Meridian Medicaid |
$1,050.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,198.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,103.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.65
|
| Rate for Payer: Nomi Health Commercial |
$1,007.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$921.75
|
| Rate for Payer: PACE Medicare |
$1,816.41
|
| Rate for Payer: PACE SWMI |
$1,912.01
|
| Rate for Payer: PHP Commercial |
$2,103.21
|
| Rate for Payer: PHP Medicaid |
$1,024.84
|
| Rate for Payer: PHP Medicare Advantage |
$1,912.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$999.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,076.85
|
| Rate for Payer: Priority Health Medicare |
$1,912.01
|
| Rate for Payer: Priority Health Narrow Network |
$861.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,912.01
|
| Rate for Payer: UHC Medicaid |
$999.98
|
| Rate for Payer: UHCCP DNSP |
$1,912.01
|
| Rate for Payer: UHCCP Medicaid |
$999.98
|
| Rate for Payer: VA VA |
$1,912.01
|
|
|
PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH
|
Professional
|
Both
|
$1,229.00
|
|
|
Service Code
|
HCPCS 43251
|
| Hospital Charge Code |
43251
|
| Min. Negotiated Rate |
$110.33 |
| Max. Negotiated Rate |
$921.75 |
| Rate for Payer: Aetna Commercial |
$228.60
|
| Rate for Payer: Aetna Medicare |
$170.60
|
| Rate for Payer: BCBS Complete |
$115.85
|
| Rate for Payer: BCBS MAPPO |
$170.60
|
| Rate for Payer: BCN Commercial |
$288.83
|
| Rate for Payer: BCN Medicare Advantage |
$170.60
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cofinity Commercial |
$245.66
|
| Rate for Payer: Cofinity Commercial |
$228.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.60
|
| Rate for Payer: Healthscope Commercial |
$204.72
|
| Rate for Payer: Healthscope Whirlpool |
$204.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.13
|
| Rate for Payer: Meridian Medicaid |
$115.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$187.66
|
| Rate for Payer: Nomi Health Commercial |
$204.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$921.75
|
| Rate for Payer: PACE SWMI |
$170.60
|
| Rate for Payer: PHP Medicare Advantage |
$170.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$351.92
|
| Rate for Payer: Priority Health Medicare |
$170.60
|
| Rate for Payer: Priority Health Narrow Network |
$351.92
|
| Rate for Payer: Railroad Medicare Medicare |
$170.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$345.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$170.60
|
| Rate for Payer: UHC Exchange |
$345.84
|
| Rate for Payer: UHC Medicaid |
$110.33
|
| Rate for Payer: UHCCP DNSP |
$170.60
|
| Rate for Payer: UHCCP Medicaid |
$110.33
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Facility
|
OP
|
$863.00
|
|
|
Service Code
|
CPT 43239
|
| Hospital Charge Code |
43239
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$472.65 |
| Max. Negotiated Rate |
$1,129.65 |
| Rate for Payer: Aetna Commercial |
$776.70
|
| Rate for Payer: Aetna Medicare |
$903.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,129.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,129.65
|
| Rate for Payer: ASR ASR |
$837.11
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$711.54
|
| Rate for Payer: BCN Commercial |
$711.54
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$690.40
|
| Rate for Payer: Cash Price |
$690.40
|
| Rate for Payer: Cofinity Commercial |
$811.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$690.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$837.11
|
| Rate for Payer: Healthscope Whirlpool |
$863.00
|
| Rate for Payer: Humana Choice PPO Medicare |
$903.72
|
| Rate for Payer: Mclaren Commercial |
$776.70
|
| Rate for Payer: Mclaren Medicaid |
$903.72
|
| Rate for Payer: Mclaren Medicare |
$903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.91
|
| Rate for Payer: Meridian Medicaid |
$496.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,039.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.55
|
| Rate for Payer: Nomi Health Commercial |
$707.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$647.25
|
| Rate for Payer: PACE Medicare |
$858.53
|
| Rate for Payer: PACE SWMI |
$903.72
|
| Rate for Payer: PHP Commercial |
$994.09
|
| Rate for Payer: PHP Medicaid |
$484.39
|
| Rate for Payer: PHP Medicare Advantage |
$903.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$756.16
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health Narrow Network |
$604.96
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC Medicaid |
$472.65
|
| Rate for Payer: UHCCP DNSP |
$903.72
|
| Rate for Payer: UHCCP Medicaid |
$472.65
|
| Rate for Payer: VA VA |
$903.72
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$863.00
|
|
|
Service Code
|
HCPCS 43239
|
| Min. Negotiated Rate |
$78.81 |
| Max. Negotiated Rate |
$647.25 |
| Rate for Payer: Aetna Commercial |
$162.88
|
| Rate for Payer: Aetna Medicare |
$121.55
|
| Rate for Payer: BCBS Complete |
$82.75
|
| Rate for Payer: BCBS MAPPO |
$121.55
|
| Rate for Payer: BCN Commercial |
$204.18
|
| Rate for Payer: BCN Medicare Advantage |
$121.55
|
| Rate for Payer: Cash Price |
$690.40
|
| Rate for Payer: Cash Price |
$690.40
|
| Rate for Payer: Cofinity Commercial |
$175.03
|
| Rate for Payer: Cofinity Commercial |
$162.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.55
|
| Rate for Payer: Healthscope Commercial |
$145.86
|
| Rate for Payer: Healthscope Whirlpool |
$145.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.63
|
| Rate for Payer: Meridian Medicaid |
$82.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$133.71
|
| Rate for Payer: Nomi Health Commercial |
$145.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$647.25
|
| Rate for Payer: PACE SWMI |
$121.55
|
| Rate for Payer: PHP Medicare Advantage |
$121.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$248.77
|
| Rate for Payer: Priority Health Medicare |
$121.55
|
| Rate for Payer: Priority Health Narrow Network |
$248.77
|
| Rate for Payer: Railroad Medicare Medicare |
$121.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$243.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$121.55
|
| Rate for Payer: UHC Exchange |
$243.50
|
| Rate for Payer: UHC Medicaid |
$78.81
|
| Rate for Payer: UHCCP DNSP |
$121.55
|
| Rate for Payer: UHCCP Medicaid |
$78.81
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Facility
|
IP
|
$863.00
|
|
|
Service Code
|
CPT 43239
|
| Hospital Charge Code |
43239
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$647.25 |
| Max. Negotiated Rate |
$863.00 |
| Rate for Payer: Aetna Commercial |
$776.70
|
| Rate for Payer: ASR ASR |
$837.11
|
| Rate for Payer: BCBS Trust/PPO |
$708.70
|
| Rate for Payer: BCN Commercial |
$708.70
|
| Rate for Payer: Cash Price |
$690.40
|
| Rate for Payer: Cofinity Commercial |
$811.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$690.40
|
| Rate for Payer: Healthscope Commercial |
$837.11
|
| Rate for Payer: Healthscope Whirlpool |
$863.00
|
| Rate for Payer: Mclaren Commercial |
$776.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.55
|
| Rate for Payer: Nomi Health Commercial |
$707.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$647.25
|
|
|
PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$863.00
|
|
|
Service Code
|
HCPCS 43239
|
| Hospital Charge Code |
43239
|
| Min. Negotiated Rate |
$78.81 |
| Max. Negotiated Rate |
$647.25 |
| Rate for Payer: Aetna Commercial |
$162.88
|
| Rate for Payer: Aetna Medicare |
$121.55
|
| Rate for Payer: BCBS Complete |
$82.75
|
| Rate for Payer: BCBS MAPPO |
$121.55
|
| Rate for Payer: BCN Commercial |
$204.18
|
| Rate for Payer: BCN Medicare Advantage |
$121.55
|
| Rate for Payer: Cash Price |
$690.40
|
| Rate for Payer: Cash Price |
$690.40
|
| Rate for Payer: Cofinity Commercial |
$175.03
|
| Rate for Payer: Cofinity Commercial |
$162.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.55
|
| Rate for Payer: Healthscope Commercial |
$145.86
|
| Rate for Payer: Healthscope Whirlpool |
$145.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.63
|
| Rate for Payer: Meridian Medicaid |
$82.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$133.71
|
| Rate for Payer: Nomi Health Commercial |
$145.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$647.25
|
| Rate for Payer: PACE SWMI |
$121.55
|
| Rate for Payer: PHP Medicare Advantage |
$121.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$248.77
|
| Rate for Payer: Priority Health Medicare |
$121.55
|
| Rate for Payer: Priority Health Narrow Network |
$248.77
|
| Rate for Payer: Railroad Medicare Medicare |
$121.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$243.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$121.55
|
| Rate for Payer: UHC Exchange |
$243.50
|
| Rate for Payer: UHC Medicaid |
$78.81
|
| Rate for Payer: UHCCP DNSP |
$121.55
|
| Rate for Payer: UHCCP Medicaid |
$78.81
|
|
|
PR EGD TRANSORAL CONTROL BLEEDING ANY METHOD
|
Professional
|
Both
|
$1,188.00
|
|
|
Service Code
|
HCPCS 43255
|
| Min. Negotiated Rate |
$112.89 |
| Max. Negotiated Rate |
$891.00 |
| Rate for Payer: Aetna Commercial |
$233.86
|
| Rate for Payer: Aetna Medicare |
$174.52
|
| Rate for Payer: BCBS Complete |
$118.53
|
| Rate for Payer: BCBS MAPPO |
$174.52
|
| Rate for Payer: BCN Commercial |
$295.30
|
| Rate for Payer: BCN Medicare Advantage |
$174.52
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cash Price |
$950.40
|
| Rate for Payer: Cofinity Commercial |
$251.31
|
| Rate for Payer: Cofinity Commercial |
$233.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.52
|
| Rate for Payer: Healthscope Commercial |
$209.42
|
| Rate for Payer: Healthscope Whirlpool |
$209.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.25
|
| Rate for Payer: Meridian Medicaid |
$118.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$191.97
|
| Rate for Payer: Nomi Health Commercial |
$209.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$891.00
|
| Rate for Payer: PACE SWMI |
$174.52
|
| Rate for Payer: PHP Medicare Advantage |
$174.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$359.80
|
| Rate for Payer: Priority Health Medicare |
$174.52
|
| Rate for Payer: Priority Health Narrow Network |
$359.80
|
| Rate for Payer: Railroad Medicare Medicare |
$174.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$353.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.52
|
| Rate for Payer: UHC Exchange |
$353.74
|
| Rate for Payer: UHC Medicaid |
$112.89
|
| Rate for Payer: UHCCP DNSP |
$174.52
|
| Rate for Payer: UHCCP Medicaid |
$112.89
|
|
|
PR EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$859.00
|
|
|
Service Code
|
HCPCS 43254
|
| Min. Negotiated Rate |
$151.02 |
| Max. Negotiated Rate |
$644.25 |
| Rate for Payer: Aetna Commercial |
$313.35
|
| Rate for Payer: Aetna Medicare |
$233.84
|
| Rate for Payer: BCBS Complete |
$158.57
|
| Rate for Payer: BCBS MAPPO |
$233.84
|
| Rate for Payer: BCN Commercial |
$397.38
|
| Rate for Payer: BCN Medicare Advantage |
$233.84
|
| Rate for Payer: Cash Price |
$687.20
|
| Rate for Payer: Cash Price |
$687.20
|
| Rate for Payer: Cofinity Commercial |
$336.73
|
| Rate for Payer: Cofinity Commercial |
$313.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.84
|
| Rate for Payer: Healthscope Commercial |
$280.61
|
| Rate for Payer: Healthscope Whirlpool |
$280.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.53
|
| Rate for Payer: Meridian Medicaid |
$158.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$257.22
|
| Rate for Payer: Nomi Health Commercial |
$280.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$644.25
|
| Rate for Payer: PACE SWMI |
$233.84
|
| Rate for Payer: PHP Medicare Advantage |
$233.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$151.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$484.20
|
| Rate for Payer: Priority Health Medicare |
$233.84
|
| Rate for Payer: Priority Health Narrow Network |
$484.20
|
| Rate for Payer: Railroad Medicare Medicare |
$233.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$476.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$233.84
|
| Rate for Payer: UHC Exchange |
$476.92
|
| Rate for Payer: UHC Medicaid |
$151.02
|
| Rate for Payer: UHCCP DNSP |
$233.84
|
| Rate for Payer: UHCCP Medicaid |
$151.02
|
|
|
PR EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST
|
Professional
|
Both
|
$1,224.00
|
|
|
Service Code
|
HCPCS 43240
|
| Min. Negotiated Rate |
$218.11 |
| Max. Negotiated Rate |
$918.00 |
| Rate for Payer: Aetna Commercial |
$453.21
|
| Rate for Payer: Aetna Medicare |
$338.22
|
| Rate for Payer: BCBS Complete |
$229.02
|
| Rate for Payer: BCBS MAPPO |
$338.22
|
| Rate for Payer: BCN Commercial |
$574.67
|
| Rate for Payer: BCN Medicare Advantage |
$338.22
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cash Price |
$979.20
|
| Rate for Payer: Cofinity Commercial |
$487.04
|
| Rate for Payer: Cofinity Commercial |
$453.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$338.22
|
| Rate for Payer: Healthscope Commercial |
$405.86
|
| Rate for Payer: Healthscope Whirlpool |
$405.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$355.13
|
| Rate for Payer: Meridian Medicaid |
$229.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$372.04
|
| Rate for Payer: Nomi Health Commercial |
$405.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$918.00
|
| Rate for Payer: PACE SWMI |
$338.22
|
| Rate for Payer: PHP Medicare Advantage |
$338.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$218.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$700.20
|
| Rate for Payer: Priority Health Medicare |
$338.22
|
| Rate for Payer: Priority Health Narrow Network |
$700.20
|
| Rate for Payer: Railroad Medicare Medicare |
$338.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$693.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$338.22
|
| Rate for Payer: UHC Exchange |
$693.29
|
| Rate for Payer: UHC Medicaid |
$218.11
|
| Rate for Payer: UHCCP DNSP |
$338.22
|
| Rate for Payer: UHCCP Medicaid |
$218.11
|
|
|
PR EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER
|
Professional
|
Both
|
$828.00
|
|
|
Service Code
|
HCPCS 43253
|
| Min. Negotiated Rate |
$146.76 |
| Max. Negotiated Rate |
$621.00 |
| Rate for Payer: Aetna Commercial |
$304.33
|
| Rate for Payer: Aetna Medicare |
$227.11
|
| Rate for Payer: BCBS Complete |
$154.10
|
| Rate for Payer: BCBS MAPPO |
$227.11
|
| Rate for Payer: BCN Commercial |
$386.44
|
| Rate for Payer: BCN Medicare Advantage |
$227.11
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cash Price |
$662.40
|
| Rate for Payer: Cofinity Commercial |
$327.04
|
| Rate for Payer: Cofinity Commercial |
$304.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.11
|
| Rate for Payer: Healthscope Commercial |
$272.53
|
| Rate for Payer: Healthscope Whirlpool |
$272.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.47
|
| Rate for Payer: Meridian Medicaid |
$154.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$249.82
|
| Rate for Payer: Nomi Health Commercial |
$272.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$621.00
|
| Rate for Payer: PACE SWMI |
$227.11
|
| Rate for Payer: PHP Medicare Advantage |
$227.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$470.85
|
| Rate for Payer: Priority Health Medicare |
$227.11
|
| Rate for Payer: Priority Health Narrow Network |
$470.85
|
| Rate for Payer: Railroad Medicare Medicare |
$227.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$464.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$227.11
|
| Rate for Payer: UHC Exchange |
$464.61
|
| Rate for Payer: UHC Medicaid |
$146.76
|
| Rate for Payer: UHCCP DNSP |
$227.11
|
| Rate for Payer: UHCCP Medicaid |
$146.76
|
|
|
PR EKG FOR INITIAL PREVENT EXAM
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS G0403
|
| Min. Negotiated Rate |
$14.67 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Aetna Commercial |
$19.66
|
| Rate for Payer: Aetna Medicare |
$14.67
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: BCBS MAPPO |
$14.67
|
| Rate for Payer: BCN Commercial |
$21.41
|
| Rate for Payer: BCN Medicare Advantage |
$14.67
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$19.66
|
| Rate for Payer: Cofinity Commercial |
$21.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.67
|
| Rate for Payer: Healthscope Commercial |
$17.60
|
| Rate for Payer: Healthscope Whirlpool |
$17.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.14
|
| Rate for Payer: Nomi Health Commercial |
$17.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$14.67
|
| Rate for Payer: PHP Medicare Advantage |
$14.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$20.35
|
| Rate for Payer: Priority Health Medicare |
$14.67
|
| Rate for Payer: Priority Health Narrow Network |
$20.35
|
| Rate for Payer: Railroad Medicare Medicare |
$14.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.67
|
| Rate for Payer: UHC Exchange |
$26.45
|
| Rate for Payer: UHCCP DNSP |
$14.67
|
|
|
PR EKG INTERPRET & REPORT PREVE
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
HCPCS G0405
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$16.50 |
| Rate for Payer: Aetna Commercial |
$10.97
|
| Rate for Payer: Aetna Medicare |
$8.19
|
| Rate for Payer: BCBS Complete |
$8.80
|
| Rate for Payer: BCBS MAPPO |
$8.19
|
| Rate for Payer: BCN Commercial |
$11.95
|
| Rate for Payer: BCN Medicare Advantage |
$8.19
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$11.79
|
| Rate for Payer: Cofinity Commercial |
$10.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.19
|
| Rate for Payer: Healthscope Commercial |
$9.83
|
| Rate for Payer: Healthscope Whirlpool |
$9.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.01
|
| Rate for Payer: Nomi Health Commercial |
$9.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.50
|
| Rate for Payer: PACE SWMI |
$8.19
|
| Rate for Payer: PHP Medicare Advantage |
$8.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$11.35
|
| Rate for Payer: Priority Health Medicare |
$8.19
|
| Rate for Payer: Priority Health Narrow Network |
$11.35
|
| Rate for Payer: Railroad Medicare Medicare |
$8.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.19
|
| Rate for Payer: UHC Exchange |
$13.65
|
| Rate for Payer: UHCCP DNSP |
$8.19
|
|
|
PR EKG TRACING FOR INITIAL PREV
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
HCPCS G0404
|
| Min. Negotiated Rate |
$6.48 |
| Max. Negotiated Rate |
$16.50 |
| Rate for Payer: Aetna Commercial |
$8.68
|
| Rate for Payer: Aetna Medicare |
$6.48
|
| Rate for Payer: BCBS Complete |
$8.80
|
| Rate for Payer: BCBS MAPPO |
$6.48
|
| Rate for Payer: BCN Commercial |
$9.46
|
| Rate for Payer: BCN Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$9.33
|
| Rate for Payer: Cofinity Commercial |
$8.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.48
|
| Rate for Payer: Healthscope Commercial |
$7.78
|
| Rate for Payer: Healthscope Whirlpool |
$7.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.13
|
| Rate for Payer: Nomi Health Commercial |
$7.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.50
|
| Rate for Payer: PACE SWMI |
$6.48
|
| Rate for Payer: PHP Medicare Advantage |
$6.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9.00
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health Narrow Network |
$9.00
|
| Rate for Payer: Railroad Medicare Medicare |
$6.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.48
|
| Rate for Payer: UHC Exchange |
$12.82
|
| Rate for Payer: UHCCP DNSP |
$6.48
|
|
|
PR ELASTIC GARMENT/COVERING
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS A4466
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: BCBS Complete |
$7.20
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.50
|
|
|
PR ELEC ALYS IMPLT BRN NPGT PRGRMG 1ST 15 MIN
|
Professional
|
Both
|
$108.00
|
|
|
Service Code
|
HCPCS 95983
|
| Min. Negotiated Rate |
$26.84 |
| Max. Negotiated Rate |
$81.50 |
| Rate for Payer: Aetna Commercial |
$55.81
|
| Rate for Payer: Aetna Medicare |
$41.65
|
| Rate for Payer: BCBS Complete |
$28.18
|
| Rate for Payer: BCBS MAPPO |
$41.65
|
| Rate for Payer: BCN Commercial |
$72.21
|
| Rate for Payer: BCN Medicare Advantage |
$41.65
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cofinity Commercial |
$55.81
|
| Rate for Payer: Cofinity Commercial |
$59.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.65
|
| Rate for Payer: Healthscope Commercial |
$49.98
|
| Rate for Payer: Healthscope Whirlpool |
$49.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.73
|
| Rate for Payer: Meridian Medicaid |
$28.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.81
|
| Rate for Payer: Nomi Health Commercial |
$49.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.00
|
| Rate for Payer: PACE SWMI |
$41.65
|
| Rate for Payer: PHP Medicare Advantage |
$41.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$66.59
|
| Rate for Payer: Priority Health Medicare |
$41.65
|
| Rate for Payer: Priority Health Narrow Network |
$66.59
|
| Rate for Payer: Railroad Medicare Medicare |
$41.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$81.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.65
|
| Rate for Payer: UHC Exchange |
$81.50
|
| Rate for Payer: UHC Medicaid |
$26.84
|
| Rate for Payer: UHCCP DNSP |
$41.65
|
| Rate for Payer: UHCCP Medicaid |
$26.84
|
|
|
PR ELEC ALYS IMPLT BRN NPGT PRGRMG EA ADDL 15 MIN
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 95984
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$71.90 |
| Rate for Payer: Aetna Commercial |
$49.15
|
| Rate for Payer: Aetna Medicare |
$36.68
|
| Rate for Payer: BCBS Complete |
$24.82
|
| Rate for Payer: BCBS MAPPO |
$36.68
|
| Rate for Payer: BCN Commercial |
$63.74
|
| Rate for Payer: BCN Medicare Advantage |
$36.68
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$52.82
|
| Rate for Payer: Cofinity Commercial |
$49.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.68
|
| Rate for Payer: Healthscope Commercial |
$44.02
|
| Rate for Payer: Healthscope Whirlpool |
$44.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.51
|
| Rate for Payer: Meridian Medicaid |
$24.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.35
|
| Rate for Payer: Nomi Health Commercial |
$44.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.50
|
| Rate for Payer: PACE SWMI |
$36.68
|
| Rate for Payer: PHP Medicare Advantage |
$36.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$58.78
|
| Rate for Payer: Priority Health Medicare |
$36.68
|
| Rate for Payer: Priority Health Narrow Network |
$58.78
|
| Rate for Payer: Railroad Medicare Medicare |
$36.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$71.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.68
|
| Rate for Payer: UHC Exchange |
$71.90
|
| Rate for Payer: UHC Medicaid |
$23.64
|
| Rate for Payer: UHCCP DNSP |
$36.68
|
| Rate for Payer: UHCCP Medicaid |
$23.64
|
|
|
PR ELEC ALYS IMPLT CPLX CN NPGT PRGRMG
|
Professional
|
Both
|
$113.00
|
|
|
Service Code
|
HCPCS 95977
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$86.04 |
| Rate for Payer: Aetna Commercial |
$56.37
|
| Rate for Payer: Aetna Medicare |
$42.07
|
| Rate for Payer: BCBS Complete |
$28.40
|
| Rate for Payer: BCBS MAPPO |
$42.07
|
| Rate for Payer: BCN Commercial |
$74.20
|
| Rate for Payer: BCN Medicare Advantage |
$42.07
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cofinity Commercial |
$60.58
|
| Rate for Payer: Cofinity Commercial |
$56.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.07
|
| Rate for Payer: Healthscope Commercial |
$50.48
|
| Rate for Payer: Healthscope Whirlpool |
$50.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.17
|
| Rate for Payer: Meridian Medicaid |
$28.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.28
|
| Rate for Payer: Nomi Health Commercial |
$50.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.75
|
| Rate for Payer: PACE SWMI |
$42.07
|
| Rate for Payer: PHP Medicare Advantage |
$42.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$68.43
|
| Rate for Payer: Priority Health Medicare |
$42.07
|
| Rate for Payer: Priority Health Narrow Network |
$68.43
|
| Rate for Payer: Railroad Medicare Medicare |
$42.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$86.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.07
|
| Rate for Payer: UHC Exchange |
$86.04
|
| Rate for Payer: UHC Medicaid |
$27.05
|
| Rate for Payer: UHCCP DNSP |
$42.07
|
| Rate for Payer: UHCCP Medicaid |
$27.05
|
|
|
PR ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
HCPCS 95972
|
| Min. Negotiated Rate |
$22.37 |
| Max. Negotiated Rate |
$129.75 |
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: Aetna Medicare |
$34.85
|
| Rate for Payer: Aetna Medicare |
$34.85
|
| Rate for Payer: BCBS Complete |
$23.49
|
| Rate for Payer: BCBS Complete |
$23.49
|
| Rate for Payer: BCBS MAPPO |
$34.85
|
| Rate for Payer: BCBS MAPPO |
$34.85
|
| Rate for Payer: BCN Commercial |
$58.76
|
| Rate for Payer: BCN Commercial |
$58.76
|
| Rate for Payer: BCN Medicare Advantage |
$34.85
|
| Rate for Payer: BCN Medicare Advantage |
$34.85
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cash Price |
$394.40
|
| Rate for Payer: Cofinity Commercial |
$46.70
|
| Rate for Payer: Cofinity Commercial |
$50.18
|
| Rate for Payer: Cofinity Commercial |
$46.70
|
| Rate for Payer: Cofinity Commercial |
$50.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.85
|
| Rate for Payer: Healthscope Commercial |
$41.82
|
| Rate for Payer: Healthscope Commercial |
$41.82
|
| Rate for Payer: Healthscope Whirlpool |
$41.82
|
| Rate for Payer: Healthscope Whirlpool |
$41.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.59
|
| Rate for Payer: Meridian Medicaid |
$23.49
|
| Rate for Payer: Meridian Medicaid |
$23.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.34
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$369.75
|
| Rate for Payer: PACE SWMI |
$34.85
|
| Rate for Payer: PACE SWMI |
$34.85
|
| Rate for Payer: PHP Medicare Advantage |
$34.85
|
| Rate for Payer: PHP Medicare Advantage |
$34.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$54.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$54.19
|
| Rate for Payer: Priority Health Medicare |
$34.85
|
| Rate for Payer: Priority Health Medicare |
$34.85
|
| Rate for Payer: Priority Health Narrow Network |
$54.19
|
| Rate for Payer: Priority Health Narrow Network |
$54.19
|
| Rate for Payer: Railroad Medicare Medicare |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$67.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34.85
|
| Rate for Payer: UHC Exchange |
$67.65
|
| Rate for Payer: UHC Exchange |
$67.65
|
| Rate for Payer: UHC Medicaid |
$22.37
|
| Rate for Payer: UHC Medicaid |
$22.37
|
| Rate for Payer: UHCCP DNSP |
$34.85
|
| Rate for Payer: UHCCP DNSP |
$34.85
|
| Rate for Payer: UHCCP Medicaid |
$22.37
|
| Rate for Payer: UHCCP Medicaid |
$22.37
|
|
|
PR ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 95970
|
| Min. Negotiated Rate |
$10.22 |
| Max. Negotiated Rate |
$118.50 |
| Rate for Payer: Aetna Commercial |
$21.27
|
| Rate for Payer: Aetna Medicare |
$15.87
|
| Rate for Payer: BCBS Complete |
$10.73
|
| Rate for Payer: BCBS MAPPO |
$15.87
|
| Rate for Payer: BCN Commercial |
$27.39
|
| Rate for Payer: BCN Medicare Advantage |
$15.87
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$21.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.87
|
| Rate for Payer: Healthscope Commercial |
$19.04
|
| Rate for Payer: Healthscope Whirlpool |
$19.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.66
|
| Rate for Payer: Meridian Medicaid |
$10.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.46
|
| Rate for Payer: Nomi Health Commercial |
$19.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
| Rate for Payer: PACE SWMI |
$15.87
|
| Rate for Payer: PHP Medicare Advantage |
$15.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$25.26
|
| Rate for Payer: Priority Health Medicare |
$15.87
|
| Rate for Payer: Priority Health Narrow Network |
$25.26
|
| Rate for Payer: Railroad Medicare Medicare |
$15.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.87
|
| Rate for Payer: UHC Exchange |
$30.59
|
| Rate for Payer: UHC Medicaid |
$10.22
|
| Rate for Payer: UHCCP DNSP |
$15.87
|
| Rate for Payer: UHCCP Medicaid |
$10.22
|
|
|
PR ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG
|
Professional
|
Both
|
$173.00
|
|
|
Service Code
|
HCPCS 95971
|
| Min. Negotiated Rate |
$21.94 |
| Max. Negotiated Rate |
$129.75 |
| Rate for Payer: Aetna Commercial |
$45.80
|
| Rate for Payer: Aetna Medicare |
$34.18
|
| Rate for Payer: BCBS Complete |
$23.04
|
| Rate for Payer: BCBS MAPPO |
$34.18
|
| Rate for Payer: BCN Commercial |
$57.27
|
| Rate for Payer: BCN Medicare Advantage |
$34.18
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cofinity Commercial |
$49.22
|
| Rate for Payer: Cofinity Commercial |
$45.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.18
|
| Rate for Payer: Healthscope Commercial |
$41.02
|
| Rate for Payer: Healthscope Whirlpool |
$41.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.89
|
| Rate for Payer: Meridian Medicaid |
$23.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.60
|
| Rate for Payer: Nomi Health Commercial |
$41.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.75
|
| Rate for Payer: PACE SWMI |
$34.18
|
| Rate for Payer: PHP Medicare Advantage |
$34.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$52.82
|
| Rate for Payer: Priority Health Medicare |
$34.18
|
| Rate for Payer: Priority Health Narrow Network |
$52.82
|
| Rate for Payer: Railroad Medicare Medicare |
$34.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$66.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$34.18
|
| Rate for Payer: UHC Exchange |
$66.44
|
| Rate for Payer: UHC Medicaid |
$21.94
|
| Rate for Payer: UHCCP DNSP |
$34.18
|
| Rate for Payer: UHCCP Medicaid |
$21.94
|
|
|
PR ELEC ALYS IMPLT SMPL CN NPGT PRGRMG
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS 95976
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$65.67 |
| Rate for Payer: Aetna Commercial |
$42.17
|
| Rate for Payer: Aetna Medicare |
$31.47
|
| Rate for Payer: BCBS Complete |
$21.25
|
| Rate for Payer: BCBS MAPPO |
$31.47
|
| Rate for Payer: BCN Commercial |
$55.28
|
| Rate for Payer: BCN Medicare Advantage |
$31.47
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cofinity Commercial |
$42.17
|
| Rate for Payer: Cofinity Commercial |
$45.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.47
|
| Rate for Payer: Healthscope Commercial |
$37.76
|
| Rate for Payer: Healthscope Whirlpool |
$37.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.04
|
| Rate for Payer: Meridian Medicaid |
$21.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.62
|
| Rate for Payer: Nomi Health Commercial |
$37.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.25
|
| Rate for Payer: PACE SWMI |
$31.47
|
| Rate for Payer: PHP Medicare Advantage |
$31.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$50.97
|
| Rate for Payer: Priority Health Medicare |
$31.47
|
| Rate for Payer: Priority Health Narrow Network |
$50.97
|
| Rate for Payer: Railroad Medicare Medicare |
$31.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$65.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.47
|
| Rate for Payer: UHC Exchange |
$65.67
|
| Rate for Payer: UHC Medicaid |
$20.24
|
| Rate for Payer: UHCCP DNSP |
$31.47
|
| Rate for Payer: UHCCP Medicaid |
$20.24
|
|
