|
PR DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL
|
Professional
|
Both
|
$615.00
|
|
|
Service Code
|
HCPCS 64635
|
| Min. Negotiated Rate |
$122.90 |
| Max. Negotiated Rate |
$825.20 |
| Rate for Payer: Aetna Commercial |
$283.74
|
| Rate for Payer: Aetna Medicare |
$307.50
|
| Rate for Payer: BCBS Complete |
$129.04
|
| Rate for Payer: BCBS Trust/PPO |
$825.20
|
| Rate for Payer: BCN Commercial |
$646.03
|
| Rate for Payer: Cash Price |
$492.00
|
| Rate for Payer: Cash Price |
$492.00
|
| Rate for Payer: Meridian Medicaid |
$129.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$122.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.01
|
| Rate for Payer: Priority Health Narrow Network |
$327.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$296.66
|
| Rate for Payer: UHC Exchange |
$296.66
|
| Rate for Payer: UHCCP Medicaid |
$122.90
|
|
|
PR DTAP-HEPB-IPV VACCINE INTRAMUSCULAR
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 90723
|
| Min. Negotiated Rate |
$48.80 |
| Max. Negotiated Rate |
$117.56 |
| Rate for Payer: Aetna Commercial |
$95.50
|
| Rate for Payer: Aetna Medicare |
$61.00
|
| Rate for Payer: BCBS Complete |
$48.80
|
| Rate for Payer: BCBS Trust/PPO |
$89.92
|
| Rate for Payer: BCN Commercial |
$88.25
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$117.56
|
| Rate for Payer: UHC Exchange |
$117.56
|
|
|
PR DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR
|
Professional
|
Both
|
$163.00
|
|
|
Service Code
|
HCPCS 90697
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$181.02 |
| Rate for Payer: Aetna Commercial |
$154.01
|
| Rate for Payer: Aetna Medicare |
$81.50
|
| Rate for Payer: BCBS Complete |
$65.20
|
| Rate for Payer: BCBS Trust/PPO |
$175.01
|
| Rate for Payer: BCN Commercial |
$175.01
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$181.02
|
| Rate for Payer: UHC Exchange |
$181.02
|
|
|
PR DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE
|
Professional
|
Both
|
$110.00
|
|
|
Service Code
|
HCPCS 90698
|
| Min. Negotiated Rate |
$44.00 |
| Max. Negotiated Rate |
$137.42 |
| Rate for Payer: Aetna Commercial |
$118.20
|
| Rate for Payer: Aetna Medicare |
$55.00
|
| Rate for Payer: BCBS Complete |
$44.00
|
| Rate for Payer: BCBS Trust/PPO |
$109.23
|
| Rate for Payer: BCN Commercial |
$109.23
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$137.42
|
| Rate for Payer: UHC Exchange |
$137.42
|
|
|
PR DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE
|
Professional
|
Both
|
$68.00
|
|
|
Service Code
|
HCPCS 90696
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$74.20 |
| Rate for Payer: Aetna Commercial |
$62.89
|
| Rate for Payer: Aetna Medicare |
$34.00
|
| Rate for Payer: BCBS Complete |
$27.20
|
| Rate for Payer: BCBS Trust/PPO |
$59.91
|
| Rate for Payer: BCN Commercial |
$59.91
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.20
|
| Rate for Payer: UHC Exchange |
$74.20
|
|
|
PR DTP/HIB VACCINE,IM
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 90720
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$53.30 |
| Rate for Payer: Aetna Medicare |
$41.00
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
|
|
PR DT VACCINE YOUNGER THAN 7 YRS FOR IM USE
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 90702
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$79.31 |
| Rate for Payer: Aetna Commercial |
$67.16
|
| Rate for Payer: Aetna Medicare |
$22.50
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS Trust/PPO |
$79.01
|
| Rate for Payer: BCN Commercial |
$79.01
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$79.31
|
| Rate for Payer: UHC Exchange |
$79.31
|
|
|
PR DUODENAL INTUBAT W/IMAG GUIDED SINGLE SPECIMEN
|
Professional
|
Both
|
$485.00
|
|
|
Service Code
|
HCPCS 43756
|
| Min. Negotiated Rate |
$32.16 |
| Max. Negotiated Rate |
$409.52 |
| Rate for Payer: Aetna Commercial |
$67.03
|
| Rate for Payer: Aetna Medicare |
$242.50
|
| Rate for Payer: BCBS Complete |
$33.77
|
| Rate for Payer: BCBS Trust/PPO |
$194.41
|
| Rate for Payer: BCN Commercial |
$409.52
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Meridian Medicaid |
$33.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.69
|
| Rate for Payer: Priority Health Narrow Network |
$90.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$69.46
|
| Rate for Payer: UHC Exchange |
$69.46
|
| Rate for Payer: UHCCP Medicaid |
$32.16
|
|
|
PR DUODENOTOMY EXPLORATION/BX/FOREIGN BODY REMOVAL
|
Professional
|
Both
|
$2,936.00
|
|
|
Service Code
|
HCPCS 44010
|
| Min. Negotiated Rate |
$541.66 |
| Max. Negotiated Rate |
$1,969.50 |
| Rate for Payer: Aetna Commercial |
$1,155.16
|
| Rate for Payer: Aetna Medicare |
$1,468.00
|
| Rate for Payer: BCBS Complete |
$568.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,969.50
|
| Rate for Payer: BCN Commercial |
$1,237.34
|
| Rate for Payer: Cash Price |
$2,348.80
|
| Rate for Payer: Cash Price |
$2,348.80
|
| Rate for Payer: Meridian Medicaid |
$568.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$541.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,908.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,518.93
|
| Rate for Payer: Priority Health Narrow Network |
$1,518.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,042.04
|
| Rate for Payer: UHC Exchange |
$1,042.04
|
| Rate for Payer: UHCCP Medicaid |
$541.66
|
|
|
PR DUOL EXCLUSION W/GASTROJEJUNOSTOMY PNCRTC INJ
|
Professional
|
Both
|
$6,281.00
|
|
|
Service Code
|
HCPCS 48547
|
| Min. Negotiated Rate |
$749.66 |
| Max. Negotiated Rate |
$4,082.65 |
| Rate for Payer: Aetna Commercial |
$2,429.46
|
| Rate for Payer: Aetna Medicare |
$3,140.50
|
| Rate for Payer: BCBS Complete |
$1,206.15
|
| Rate for Payer: BCBS Trust/PPO |
$749.66
|
| Rate for Payer: BCN Commercial |
$2,612.47
|
| Rate for Payer: Cash Price |
$5,024.80
|
| Rate for Payer: Cash Price |
$5,024.80
|
| Rate for Payer: Meridian Medicaid |
$1,206.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,148.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,082.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,201.33
|
| Rate for Payer: Priority Health Narrow Network |
$3,201.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,158.34
|
| Rate for Payer: UHC Exchange |
$2,158.34
|
| Rate for Payer: UHCCP Medicaid |
$1,148.71
|
|
|
PR DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL BI STD
|
Professional
|
Both
|
$78.00
|
|
|
Service Code
|
HCPCS 93985
|
| Min. Negotiated Rate |
$24.07 |
| Max. Negotiated Rate |
$363.58 |
| Rate for Payer: Aetna Commercial |
$282.30
|
| Rate for Payer: Aetna Medicare |
$39.00
|
| Rate for Payer: BCBS Complete |
$25.27
|
| Rate for Payer: BCBS Trust/PPO |
$243.55
|
| Rate for Payer: BCN Commercial |
$363.58
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Meridian Medicaid |
$25.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.21
|
| Rate for Payer: Priority Health Narrow Network |
$50.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$282.20
|
| Rate for Payer: UHC Exchange |
$282.20
|
| Rate for Payer: UHCCP Medicaid |
$24.07
|
|
|
PR DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 93986
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$216.49 |
| Rate for Payer: Aetna Commercial |
$137.95
|
| Rate for Payer: Aetna Medicare |
$24.00
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Trust/PPO |
$61.81
|
| Rate for Payer: BCN Commercial |
$216.49
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.21
|
| Rate for Payer: Priority Health Narrow Network |
$31.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$163.97
|
| Rate for Payer: UHC Exchange |
$163.97
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
|
|
PR DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
HCPCS 93880
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$288.60 |
| Rate for Payer: Aetna Commercial |
$211.27
|
| Rate for Payer: Aetna Medicare |
$222.00
|
| Rate for Payer: BCBS Complete |
$25.05
|
| Rate for Payer: BCBS Trust/PPO |
$80.30
|
| Rate for Payer: BCN Commercial |
$280.02
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Meridian Medicaid |
$25.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$288.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.66
|
| Rate for Payer: Priority Health Narrow Network |
$50.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$242.79
|
| Rate for Payer: UHC Exchange |
$242.79
|
| Rate for Payer: UHCCP Medicaid |
$23.86
|
|
|
PR DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY
|
Professional
|
Both
|
$318.00
|
|
|
Service Code
|
HCPCS 93882
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$310.64 |
| Rate for Payer: Aetna Commercial |
$137.60
|
| Rate for Payer: Aetna Medicare |
$159.00
|
| Rate for Payer: BCBS Complete |
$15.44
|
| Rate for Payer: BCBS Trust/PPO |
$310.64
|
| Rate for Payer: BCN Commercial |
$181.79
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Meridian Medicaid |
$15.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.66
|
| Rate for Payer: Priority Health Narrow Network |
$31.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$164.70
|
| Rate for Payer: UHC Exchange |
$164.70
|
| Rate for Payer: UHCCP Medicaid |
$14.70
|
|
|
PR DUPLEX SCAN HEMODIALYSIS ACCESS
|
Professional
|
Both
|
$347.00
|
|
|
Service Code
|
HCPCS 93990
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$225.55 |
| Rate for Payer: Aetna Commercial |
$138.39
|
| Rate for Payer: Aetna Commercial |
$138.39
|
| Rate for Payer: Aetna Medicare |
$173.50
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Trust/PPO |
$16.91
|
| Rate for Payer: BCBS Trust/PPO |
$16.91
|
| Rate for Payer: BCN Commercial |
$214.53
|
| Rate for Payer: BCN Commercial |
$214.53
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Cash Price |
$277.60
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.21
|
| Rate for Payer: Priority Health Narrow Network |
$31.21
|
| Rate for Payer: Priority Health Narrow Network |
$31.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$196.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$196.83
|
| Rate for Payer: UHC Exchange |
$196.83
|
| Rate for Payer: UHC Exchange |
$196.83
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
|
|
PR DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE
|
Professional
|
Both
|
$398.00
|
|
|
Service Code
|
HCPCS 93978
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$430.56 |
| Rate for Payer: Aetna Commercial |
$199.98
|
| Rate for Payer: Aetna Commercial |
$199.98
|
| Rate for Payer: Aetna Medicare |
$199.00
|
| Rate for Payer: Aetna Medicare |
$40.50
|
| Rate for Payer: BCBS Complete |
$25.49
|
| Rate for Payer: BCBS Complete |
$25.49
|
| Rate for Payer: BCBS Trust/PPO |
$430.56
|
| Rate for Payer: BCBS Trust/PPO |
$430.56
|
| Rate for Payer: BCN Commercial |
$264.37
|
| Rate for Payer: BCN Commercial |
$264.37
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Cash Price |
$318.40
|
| Rate for Payer: Meridian Medicaid |
$25.49
|
| Rate for Payer: Meridian Medicaid |
$25.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.66
|
| Rate for Payer: Priority Health Narrow Network |
$50.66
|
| Rate for Payer: Priority Health Narrow Network |
$50.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$234.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$234.02
|
| Rate for Payer: UHC Exchange |
$234.02
|
| Rate for Payer: UHC Exchange |
$234.02
|
| Rate for Payer: UHCCP Medicaid |
$24.28
|
| Rate for Payer: UHCCP Medicaid |
$24.28
|
|
|
PR DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD
|
Professional
|
Both
|
$275.00
|
|
|
Service Code
|
HCPCS 93979
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$178.75 |
| Rate for Payer: Aetna Commercial |
$129.02
|
| Rate for Payer: Aetna Commercial |
$129.02
|
| Rate for Payer: Aetna Medicare |
$137.50
|
| Rate for Payer: Aetna Medicare |
$26.00
|
| Rate for Payer: BCBS Complete |
$15.44
|
| Rate for Payer: BCBS Complete |
$15.44
|
| Rate for Payer: BCBS Trust/PPO |
$84.00
|
| Rate for Payer: BCBS Trust/PPO |
$84.00
|
| Rate for Payer: BCN Commercial |
$171.52
|
| Rate for Payer: BCN Commercial |
$171.52
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Meridian Medicaid |
$15.44
|
| Rate for Payer: Meridian Medicaid |
$15.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.66
|
| Rate for Payer: Priority Health Narrow Network |
$31.66
|
| Rate for Payer: Priority Health Narrow Network |
$31.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$162.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$162.11
|
| Rate for Payer: UHC Exchange |
$162.11
|
| Rate for Payer: UHC Exchange |
$162.11
|
| Rate for Payer: UHCCP Medicaid |
$14.70
|
| Rate for Payer: UHCCP Medicaid |
$14.70
|
|
|
PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
HCPCS 93975
|
| Min. Negotiated Rate |
$34.51 |
| Max. Negotiated Rate |
$389.96 |
| Rate for Payer: Aetna Commercial |
$294.18
|
| Rate for Payer: Aetna Commercial |
$294.18
|
| Rate for Payer: Aetna Medicare |
$129.00
|
| Rate for Payer: Aetna Medicare |
$309.50
|
| Rate for Payer: BCBS Complete |
$36.24
|
| Rate for Payer: BCBS Complete |
$36.24
|
| Rate for Payer: BCBS Trust/PPO |
$57.58
|
| Rate for Payer: BCBS Trust/PPO |
$57.58
|
| Rate for Payer: BCN Commercial |
$389.96
|
| Rate for Payer: BCN Commercial |
$389.96
|
| Rate for Payer: Cash Price |
$495.20
|
| Rate for Payer: Cash Price |
$495.20
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Meridian Medicaid |
$36.24
|
| Rate for Payer: Meridian Medicaid |
$36.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$402.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.28
|
| Rate for Payer: Priority Health Narrow Network |
$73.28
|
| Rate for Payer: Priority Health Narrow Network |
$73.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$374.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$374.18
|
| Rate for Payer: UHC Exchange |
$374.18
|
| Rate for Payer: UHC Exchange |
$374.18
|
| Rate for Payer: UHCCP Medicaid |
$34.51
|
| Rate for Payer: UHCCP Medicaid |
$34.51
|
|
|
PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 93976
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$547.85 |
| Rate for Payer: Aetna Commercial |
$154.25
|
| Rate for Payer: Aetna Commercial |
$154.25
|
| Rate for Payer: Aetna Medicare |
$90.50
|
| Rate for Payer: Aetna Medicare |
$321.50
|
| Rate for Payer: BCBS Complete |
$25.05
|
| Rate for Payer: BCBS Complete |
$25.05
|
| Rate for Payer: BCBS Trust/PPO |
$547.85
|
| Rate for Payer: BCBS Trust/PPO |
$547.85
|
| Rate for Payer: BCN Commercial |
$232.12
|
| Rate for Payer: BCN Commercial |
$232.12
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Meridian Medicaid |
$25.05
|
| Rate for Payer: Meridian Medicaid |
$25.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.66
|
| Rate for Payer: Priority Health Narrow Network |
$50.66
|
| Rate for Payer: Priority Health Narrow Network |
$50.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.78
|
| Rate for Payer: UHC Exchange |
$214.78
|
| Rate for Payer: UHC Exchange |
$214.78
|
| Rate for Payer: UHCCP Medicaid |
$23.86
|
| Rate for Payer: UHCCP Medicaid |
$23.86
|
|
|
PR DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 93925
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$351.85 |
| Rate for Payer: Aetna Commercial |
$268.26
|
| Rate for Payer: Aetna Commercial |
$268.26
|
| Rate for Payer: Aetna Medicare |
$51.00
|
| Rate for Payer: Aetna Medicare |
$214.00
|
| Rate for Payer: BCBS Complete |
$24.60
|
| Rate for Payer: BCBS Complete |
$24.60
|
| Rate for Payer: BCBS Trust/PPO |
$160.60
|
| Rate for Payer: BCBS Trust/PPO |
$160.60
|
| Rate for Payer: BCN Commercial |
$351.85
|
| Rate for Payer: BCN Commercial |
$351.85
|
| Rate for Payer: Cash Price |
$342.40
|
| Rate for Payer: Cash Price |
$342.40
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Meridian Medicaid |
$24.60
|
| Rate for Payer: Meridian Medicaid |
$24.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.21
|
| Rate for Payer: Priority Health Narrow Network |
$50.21
|
| Rate for Payer: Priority Health Narrow Network |
$50.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$305.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$305.38
|
| Rate for Payer: UHC Exchange |
$305.38
|
| Rate for Payer: UHC Exchange |
$305.38
|
| Rate for Payer: UHCCP Medicaid |
$23.43
|
| Rate for Payer: UHCCP Medicaid |
$23.43
|
|
|
PR DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY
|
Professional
|
Both
|
$334.00
|
|
|
Service Code
|
HCPCS 93926
|
| Min. Negotiated Rate |
$14.27 |
| Max. Negotiated Rate |
$416.83 |
| Rate for Payer: Aetna Commercial |
$137.57
|
| Rate for Payer: Aetna Commercial |
$137.57
|
| Rate for Payer: Aetna Medicare |
$167.00
|
| Rate for Payer: Aetna Medicare |
$20.50
|
| Rate for Payer: BCBS Complete |
$14.98
|
| Rate for Payer: BCBS Complete |
$14.98
|
| Rate for Payer: BCBS Trust/PPO |
$416.83
|
| Rate for Payer: BCBS Trust/PPO |
$416.83
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: BCN Commercial |
$209.15
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Meridian Medicaid |
$14.98
|
| Rate for Payer: Meridian Medicaid |
$14.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.76
|
| Rate for Payer: Priority Health Narrow Network |
$30.76
|
| Rate for Payer: Priority Health Narrow Network |
$30.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$197.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$197.10
|
| Rate for Payer: UHC Exchange |
$197.10
|
| Rate for Payer: UHC Exchange |
$197.10
|
| Rate for Payer: UHCCP Medicaid |
$14.27
|
| Rate for Payer: UHCCP Medicaid |
$14.27
|
|
|
PR DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY
|
Professional
|
Both
|
$406.00
|
|
|
Service Code
|
HCPCS 93930
|
| Min. Negotiated Rate |
$21.13 |
| Max. Negotiated Rate |
$286.85 |
| Rate for Payer: Aetna Commercial |
$218.52
|
| Rate for Payer: Aetna Commercial |
$218.52
|
| Rate for Payer: Aetna Medicare |
$203.00
|
| Rate for Payer: Aetna Medicare |
$32.00
|
| Rate for Payer: BCBS Complete |
$25.05
|
| Rate for Payer: BCBS Complete |
$25.05
|
| Rate for Payer: BCBS Trust/PPO |
$21.13
|
| Rate for Payer: BCBS Trust/PPO |
$21.13
|
| Rate for Payer: BCN Commercial |
$286.85
|
| Rate for Payer: BCN Commercial |
$286.85
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Cash Price |
$324.80
|
| Rate for Payer: Meridian Medicaid |
$25.05
|
| Rate for Payer: Meridian Medicaid |
$25.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.66
|
| Rate for Payer: Priority Health Narrow Network |
$50.66
|
| Rate for Payer: Priority Health Narrow Network |
$50.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$239.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$239.61
|
| Rate for Payer: UHC Exchange |
$239.61
|
| Rate for Payer: UHC Exchange |
$239.61
|
| Rate for Payer: UHCCP Medicaid |
$23.86
|
| Rate for Payer: UHCCP Medicaid |
$23.86
|
|
|
PR DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 93931
|
| Min. Negotiated Rate |
$12.68 |
| Max. Negotiated Rate |
$180.81 |
| Rate for Payer: Aetna Commercial |
$136.50
|
| Rate for Payer: Aetna Commercial |
$136.50
|
| Rate for Payer: Aetna Medicare |
$136.00
|
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Trust/PPO |
$12.68
|
| Rate for Payer: BCBS Trust/PPO |
$12.68
|
| Rate for Payer: BCN Commercial |
$180.81
|
| Rate for Payer: BCN Commercial |
$180.81
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.21
|
| Rate for Payer: Priority Health Narrow Network |
$31.21
|
| Rate for Payer: Priority Health Narrow Network |
$31.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.01
|
| Rate for Payer: UHC Exchange |
$160.01
|
| Rate for Payer: UHC Exchange |
$160.01
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
|
|
PR DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 93970
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$276.10 |
| Rate for Payer: Aetna Commercial |
$206.98
|
| Rate for Payer: Aetna Commercial |
$206.98
|
| Rate for Payer: Aetna Medicare |
$58.50
|
| Rate for Payer: Aetna Medicare |
$211.00
|
| Rate for Payer: BCBS Complete |
$21.47
|
| Rate for Payer: BCBS Complete |
$21.47
|
| Rate for Payer: BCBS Trust/PPO |
$8.98
|
| Rate for Payer: BCBS Trust/PPO |
$8.98
|
| Rate for Payer: BCN Commercial |
$276.10
|
| Rate for Payer: BCN Commercial |
$276.10
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Meridian Medicaid |
$21.47
|
| Rate for Payer: Meridian Medicaid |
$21.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.88
|
| Rate for Payer: Priority Health Narrow Network |
$43.88
|
| Rate for Payer: Priority Health Narrow Network |
$43.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$248.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$248.59
|
| Rate for Payer: UHC Exchange |
$248.59
|
| Rate for Payer: UHC Exchange |
$248.59
|
| Rate for Payer: UHCCP Medicaid |
$20.45
|
| Rate for Payer: UHCCP Medicaid |
$20.45
|
|
|
PR DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY
|
Professional
|
Both
|
$279.00
|
|
|
Service Code
|
HCPCS 93971
|
| Min. Negotiated Rate |
$13.21 |
| Max. Negotiated Rate |
$181.35 |
| Rate for Payer: Aetna Commercial |
$130.22
|
| Rate for Payer: Aetna Commercial |
$130.22
|
| Rate for Payer: Aetna Medicare |
$139.50
|
| Rate for Payer: Aetna Medicare |
$37.00
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCBS Trust/PPO |
$100.91
|
| Rate for Payer: BCBS Trust/PPO |
$100.91
|
| Rate for Payer: BCN Commercial |
$174.95
|
| Rate for Payer: BCN Commercial |
$174.95
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Meridian Medicaid |
$13.87
|
| Rate for Payer: Meridian Medicaid |
$13.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.05
|
| Rate for Payer: Priority Health Narrow Network |
$28.05
|
| Rate for Payer: Priority Health Narrow Network |
$28.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$163.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$163.99
|
| Rate for Payer: UHC Exchange |
$163.99
|
| Rate for Payer: UHC Exchange |
$163.99
|
| Rate for Payer: UHCCP Medicaid |
$13.21
|
| Rate for Payer: UHCCP Medicaid |
$13.21
|
|
